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Prostate cancer that develops in the 5th or 6th decade of life is
more aggressive than later onset prostate cancer, and is more likely to
first present with symptoms of metastases. One of the arguements against
screening is that many men will 'die with prostate cancer, rather than die
from it'. I would be interested to see if by dividing prostate cancer up
(perhaps arbitrarily) into early onset and late onset disease, whether any
benefit emerges for screening only those men in the age range say 50 - 60
or 65 years. Then within this group of men, the higher risk group with
indeterminate or high PSA levels could be retested at a shorter interval
than those with initial low levels. This follows the orthodoxy that
maximising cost effectiveness for screening will ensue from targeting the
highest risk groups.
Competing interests:
No competing interests
23 July 2002
David B King
Lecturer in General Practice
Centre for General Practice, School of Population Health, University of Queensland, Herston, Q. 4006
PSA Screening in high risk population
Prostate cancer that develops in the 5th or 6th decade of life is
more aggressive than later onset prostate cancer, and is more likely to
first present with symptoms of metastases. One of the arguements against
screening is that many men will 'die with prostate cancer, rather than die
from it'. I would be interested to see if by dividing prostate cancer up
(perhaps arbitrarily) into early onset and late onset disease, whether any
benefit emerges for screening only those men in the age range say 50 - 60
or 65 years. Then within this group of men, the higher risk group with
indeterminate or high PSA levels could be retested at a shorter interval
than those with initial low levels. This follows the orthodoxy that
maximising cost effectiveness for screening will ensue from targeting the
highest risk groups.
Competing interests: No competing interests