4. Prostate cancer incidence rates rose dramatically in the late 1980s. This increase reflects improvements in detection

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4 Prostate Cancer Incidence Rates Rose Dramatically In The Late 1980s This Increase Reflects Improvements In Detection 1 (120.92 KiB) Viewed 34 times

4. Prostate cancer incidence rates rose dramatically in the late 1980s. This increase reflects improvements in detection and diagnosis through widespread use of PSA testing. In the early 1990s, prostate cancer incidence began declining and has leveled off in recent years. Over the past 20 years, the survival rate for prostate cancer has improved from 67% to 97%. The potential benefits of prostate cancer screening are obvious as screening can detect cancer early and treatment for prostate cancer may be more effective when it is found early. There are also potential risks of prostate cancer screening, including false positive test results that lead to further tests and can cause anxiety. Screening may also result in the treatment of some prostate cancers that may have never affected a man's health even if left untreated. Treatment may also lead to serious side effects such as impotence (inability to keep an erection) and incontinence (inability to control the flow of urine, resulting in leakage). In addition, here is the estimated prevalence by age group of latent prostate cancer for the U.S. population. The data for the 40-49 year age group is autopay data. Age Group 40-49 50-59 60-69 70-79 280 Prevalence 3-5% 22.1% 36.1% 37.8% 53.7% With all this in mind, is it more important to have higher sensitivity or higher specificity for prostate screening? Which cut off point would you recommend? Why? Looking at the prevalence data, how would these affect your screening efforts and recommendations? Who would you screen, how often, at what PSA level 210ng ml or 24 ng ml) and why? This question is just to ger you thinking about the importance of accurate screening.)