Member Info for JorisBonson

Schrodinger's patient! Nicely put.

"100% certain", HFH?

Up we go!!

First of all, I've found Dug Walker generally very informative but on the question of the Prostagram trial planned to begin in 12 months time I think his concerns are over-stated. As others have said, these national screening programmes take years to get going; also, millions of PSA tests are already performed annually in the USA and UK without a national screening programme existing in either country. As we all know, the PSE is an adjunct to the PSA. So, when a middle-aged chap goes to his doctor in future complaining of slow flow or getting up three times a night to pee, the doctor might well start to think about a PSE as well as a PSA and a digital rectal exam. That's not screening, it's an investigation.

Hoping to clarify things, a screening programme goes actively looking for cases; a diagnostic test is used when a patient reports symptoms to their doctor.

In the 1950s and onwards in the UK and elsewhere, there was a screening programme hoping to detect TB in the lungs of people who felt reasonably well, using a modified chest X-ray. No one doubted chest x rays were a useful diagnostic tool, but there were questions about the wider logistics, costs and ultimate benefits. In the end, it fizzled out because TB declined naturally - but we still use chest x-rays to look at the lungs.

So, whether PSE is used for big national screening programmes or not, it still has appeal for diagnosing or ruling out PC in actual patients, it seems to me.