HEAD393 Bowel Cancer Screening Specialist Practice

Question The Benefits Of Cancer Screening Outwighs The Harms. Description: Introduction, states the benefits and harms and then choose/ decide on what to write either how the befits outwigh the harm or vice versa. Specify on the type of cancer screening you want to write. example prostate cancer screening. Discuss using evidence, arguments and research. Globally not specify on one country. Answer Introduction: Screening is one of the most effective technologies used to reduce mortality associated with cancer (Drazer, Huo and Eggener 2015). Although, there is considerable argument questioning whether the benefits associated with cancer screening is worth the harm that it may implement. This essay will review the available literature evidences to explore the positive and negative side of the argument and provide personal verdict on whether the benefits associated with prostate cancer screening outweigh the harms facilitated by it. Available Evidence Review: As discussed by Duffy (2014), the aim of prostate cancer screening is detecting the malignancy at an early stage so that it is potentially treatable. However, the most abundantly used technique of prostate cancer screening is serum PSA which has been any used in medical screening for prostate cancer for over 20 years. There is mounting evidence that indicates that the controversial arguments surrounding the practice of serum PSA screening associated with prostate cancer as the technique lacks sensitivity and specificity for the early detection. Although there are various research evidences that indicates that the effectiveness of this Pioneer testing methodology. Many recent research studies have argued that serum PSA screening leads to unnecessary over- detection, biopsies, and even over- or maltreatment, facilitating more harm than benefit (Duffy 2014). Elaborating further, the article by Duffy (2014) stated that the published guidelines across the globe differ in the recommendation for serum PSA screening for prostate cancer. Also, one common factor in all of the guidelines is that men should be informed of the risks and benefits of the process before going forward with the testing. Along with that globally most of the guidelines for serum PSA prostate cancer screening also state that when that have life expectancy lesser than 10 years should not even be screened using this Pioneer technique. On another note different research studies have also stated the process specific antigen or PSA screening methods to detect early symptomatic prostate cancer as well. Also as discussed by Mühlberger et al. (2017), the mortality reduction for the trials is still conflicting and the potential gains is outweighed by the loss of quality of life due to the over diagnosis and over treatment. The medical organizations in Europe and United States including the European Association of Urology and the United State Preventative Service Task Force do not advocate using PSA based screening for routine purposes due to the uncertain benefits and possible harms (McCarthy 2013). Argument And Verdict: Although there are medical research trials that have provided substantial positive results of using PSA based prostate cancer screening in different location across the world as well. For instance, an observational study from the Austrian state of Tyrol has provided results of 30% screening related decline of prostate cancer mortality after free PSA screening introduced for the age group of men belonging to the age group of 45 to 74 years in the year of 1993. Similarly another randomized control trial study in the European continent for the screening of prostate cancer demonstrated 29% reduction in the mortality associated with prostate cancer at follow-up of 11 years after the screening and also reported a reduction in metastatic disease diagnosis of 30% and a 12 year follow-up study (Mühlberger et al. 2017). Hence it can be stated that although PSA based prostate cancer screening is the only feasible and cost-effective prostate cancer screening modality that can detect the disease at a very early stage. The advantages for this includes specialized treatment designing and evading the risk of mortality allowing the patient to live a long and comfortable life following personalized and patient centred treatment of the prostate cancer which cannot be given if the diagnosis is made at a later stage when the cancer is already advanced and is at uncontrollably malignant state (Walteret al. 2017). Similarly the negative side of the argument also indicates at considerably affected quality of life and even lower life expectancy due to over diagnosis and over treatment (Drazer, Huo and Eggener 2015). A few novel biomarkers of prostate cancer screening are being introduced by the research including 2proPSA, prostate health index, and PCA3. Hence, there is need for better and less harmful prostate cancer screening modalities are being introduced in the market in a cost effective manner so that the benefits of the screening procedure can outweigh the harms. Conclusion: On a concluding note fastest cancer screening is associated with both benefits and harms. The PSA mediated screening on the other hand has more harmful impacts than benefits that it is providing. Hence, there is need for further research to develop more cost effective and harmless methods of screening so that patient safety and wellbeing can be registered under all circumstances and the harmfulness of a screening procedure does not outweigh the potential benefits. References: Drazer, M.W., Huo, D. and Eggener, S.E., 2015. National prostate cancer screening rates after the 2012 US Preventive Services Task Force recommendation discouraging prostate-specific antigen–based screening. Journal of Clinical Oncology, 33(22), pp.2416-2423. Duffy, M.J., 2014. PSA in screening for prostate cancer: more good than harm or more harm than good?. In Advances in clinical chemistry, 66, pp. 1-23. Elsevier. Heidenreich, A., Bastian, P.J., Bellmunt, J., Bolla, M., Joniau, S., van der Kwast, T., Mason, M., Matveev, V., Wiegel, T., Zattoni, F. and Mottet, N., 2014. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent—update 2013. European urology, 65(1), pp.124-137. McCarthy, M., 2013. Harms of PSA screening outweigh benefits for most men, says American College of Physicians. BMJ: British Medical Journal (Online), 346, p. 1. Mühlberger, N., Boskovic, K., Krahn, M.D., Bremner, K.E., Oberaigner, W., Klocker, H., Horninger, W., Sroczynski, G. and Siebert, U., 2017. Benefits and harms of prostate cancer screening–predictions of the ONCOTYROL prostate cancer outcome and policy model. BMC public health, 17(1), p.596. Walter, S.D., de Koning, H.J., Hugosson, J., Talala, K., Roobol, M.J., Carlsson, S., Zappa, M., Nelen, V., Kwiatkowski, M., Páez, Á. and Moss, S., 2017. Impact of cause of death adjudication on the results of the European prostate cancer screening trial. British journal of cancer, 116(1), p.141.

HEAD393 Bowel Cancer Screening Specialist Practice

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