Article Abstract:
The value of screening for prostate cancer by measuring levels of prostate-specific antigen (PSA) remains unclear, with arguments supporting and contesting widespread screening. On one hand prostate cancer causes pain and death in thousands of men each year, but in many other men it does not cause noticeable health problems. PSA screening is not that accurate, in that two thirds of the positive tests may be false. These false positives may result in unpleasant follow-up tests, such as biopsies, or treatments with adverse side effects. Moreover, it is unclear whether early detection of prostate cancer with PSA screening leads to improved outcome. The improvement in outcome is uncertain because the effectiveness of treatment remains unclear and many detected cases may not require treatment. Doctors should inform patients about the arguments for and against PSA screening and assess the preferences of their patients.
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Article Abstract:
Colorectal cancer occurs in 160,000 people in the US every year, and 60,000 will die each year. It arises from a polyp in the colon and can take 10 to 15 years to develop. For this reason, it is amenable to early diagnosis and treatment. In the 1970s, fecal occult blood testing was introduced as a way of detecting the disease, but many studies were unable to prove that early detection reduced mortality. A 1993 study provides that proof: it found that annual fecal occult blood testing reduced mortality from colorectal cancer by 33%. In this study, stool samples were rehydrated, which increases the test's effectiveness. It seems prudent to recommend annual fecal occult blood testing in those over 50. In addition, flexible sigmoidoscopy should be done every three to five years in these individuals. Public education should include prevention, screening and dietary changes.
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Article Abstract:
Patients should be allowed to choose which screening test they prefer for detecting colorectal cancer. These tests include fecal blood tests every year or two, sigmoidoscopy every five years, and colonoscopy every 10 years. Sigmoidoscopy and colonoscopy are more effective, but are also more costly and uncomfortable.
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