GU Cancers 2019 | How should PSA screening be carried out to reduce the risk of harm to the patient
Andrew Vickers, PhD, of the Memorial Sloan Kettering Cancer Center, New York City, NY, discusses his views on how PSA screening should be carried out in order to reduce the risk of causing unnecessary harm to the patient. This interview was recorded at the 2019 Genitourinary Cancers Symposium, held in San Francisco, CA.
Transcript (edited for clarity):
Well what I’ve often said about prostate cancer screening is that it’s been a public health fiasco but we should carry on doing it or I would say I’m a total skeptic about PSA screening. It’s the best thing since sliced bread. So how do you put those two things together. And it’s basically to notice that when we say should we do it, as in it is PSA screening but you can do PSA screening all sorts of different ways. And like so many things in life whether something does more good than harm depends on how you do it.
We can design screening strategies in which we target the wrong man and we biopsy the wrong man and we treat the wrong man. And those strategies will do more harm than good or we can use some of the knowledge that is developed about PSA and about prostate cancer and design programs that are much more likely to do more good than harm. So the question to me isn’t does it work, should we use it? But how should we be using it so that it benefits patients, benefits more patients, harms fewer patients and does less harm to the patients that we do screen.
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