Week 2 – Summary of Paper: Prostate Specific Antigen Concentration at Age 60

On 11 September at 8pm (GMT+1) #PHTwitJC will critique the following paper:

Vickers, A et al (2010) Prostate specific antigen concentration at age 60 and death or metastasis from prostate cancer: case-control study – published in the British Medical Journal and accessible on-line here.

Why is this paper relevant to public health?

Prostate cancer is the most common cancer in men in the UK; 37,000 men are diagnosed with prostate cancer every year (incidence) and 250,000 men are currently living with the disease (prevalence) according to The Prostate Cancer Charity.

Screening for prostate cancer is controversial because of cost and uncertain long-term benefits to patients.  Prostate specific antigen (PSA) screening is widely used for the early detection of prostate cancer however there remains is a great deal of debate over the value of the PSA test as a screening test.

Summary of paper

A single measure of PSA at age 60 is associated with a man’s lifetime risk of death from prostate cancer.  Most (90%) of deaths from prostate cancer occur in men in the top quarter of PSA concentrations (>2 ng/ml), though only a minority of such men will develop fatal prostate cancer.  Men aged 60 with concentrations ≤1 ng/ml can be told that though theymight have cancer, it is unlikely to become life threatening.  At least half of men at age 60 can be exempted from further screening.  The paper suggests prostate cancer screening should instead focus on men with higher concentrations of PSA.

‘Live’ Public Health Twitter Journal Club will take place on Sunday 11th September, between 20:00 and 21:00 UK time (GMT+1). To follow and contribute to the discussion, remember to use the #PHTwitJC hashtag

The discussion points for this week are as follows:

  1. This paper uses a case-control study design – was this appropriate for this topic?
  2. Did recruitment for cases and controls affect selection bias?
  3. What confounding factors could be present?  Have these been accounted for?
  4. Study concluded that “a single measure of PSA at age 60 is associated with a man’s lifetime risk of death from prostate cancer” – are these results valid?
  5. What are the PH implications of this study? How might these influence future practice/policy?

Further reading

* CASP (Critical Appraisal Skills Programme) framework; 11 questions to help you make sense of a case control study, accessible via here

* UK National Screening Committee. Criteria for appraising the viability, effectiveness and appropriateness of a screening programme. 2009. Accessible here

* Health Knowledge Interactive Learning Module on Screening by Angela Raffle. Last accessed January 18, 2010. Accessible here

Advertisements
This entry was posted in Summaries and tagged , , , , . Bookmark the permalink.

5 Responses to Week 2 – Summary of Paper: Prostate Specific Antigen Concentration at Age 60

  1. Pingback: Week 2 of #PHTwitJC – Summary of paper updated | Bean Around The World

  2. Pingback: PHTWITJC on 11 Sept: case-control study | Public Health Twitter Journal Club

  3. Pingback: Summary of PHTwitJC #2: Prostate-Specific Antigen Concerntration at age 60 | Public Health Twitter Journal Club

  4. Pingback: Summary of PHTwitJC #2: Prostate-Specific Antigen Concerntration at age 60 | Bean Around The World

  5. The two types of fat burning cardio are steady state and interval
    training. Though I can only assume that weight loss is at least one goal for these
    clients, I will say this:. Inner thigh fat seems to be one of
    the last things on the body to burn off.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s