2024-09-25 21:06:00
Prostate cancer rates have increased in Europe since 1980, according to a study published in ‘The BMJ‘ a few weeks ago it was an indication of an overarching investigation. The conclusions of this work are that new studies have increased because the general use of the tests of the PSA [antígeno prostático específico]but death rates have not been comparatively favorable. This suggests that it is possible overdiagnosisthat is, the presence of benign tumors that are unlikely to cause symptoms or death in the patient throughout their life.
Now, the study published in ‘The New England Journal of Medicine‘ suggest that this overdiagnosis can be reduced by adding an MRI test in those with a high PSA level and offering a biopsy if the imaging does not detect suspicious lesions.
The results of this clinical trial, conducted in men 50 to 60 years old showed that the technique avoids more than half of clinically insignificant cancer diagnoses that would not require treatment and that increases the risk of failing to identify those who may become curable. Its authors recommend, based on the research, review the recommendations on these screenings.
The use of MRI in detection in screening settings is a topic that has been under debate for years. Thus, comments Álvaro Páez Borda, head of the Urology of the University Hospital of Fuenlabrada y Alaga de la rama española del European Randomized Study of Screening for Prostate Canceris actually one of the hopes of the Anti-Cancer Program of the European Union (EU). In the sentences to Science Media CenterPáez Borda points out that currently, “several countries – Spain, among others – are analyzing in the European Union the possibility of screening programs for prostate cancer that include magnetic resonance imaging.”
MRI represents an important tool for the early detection of prostate cancer, by looking at the tumor that is important for the patient’s health, points out Spanish Society of Medical Radiology (BELIEF).
The diagnosis of cancer is made by biopsy, and it is necessary that the procedure is directed and directed to the lesion that has already been observed on the MRI. This biopsy requires the use of an imaging technique such as ultrasound or MRI to obtain an effective diagnosis of the prostate tissue and allow for an early diagnosis of cancer. SERAM emphasized pthe use of MRI during all stages of prostate cancer, from diagnosis, staging and to treatment monitoring.
However, even knowing that it is a well-designed design and excellent performance, Páez Borda says “The study has been published in a system with definitions that make it ideal for any type of screen: monitoring very complete, the target population (Nordic) is very disciplined in their health habits and the cancer registry is given incredible credibility. The only surprise is the ‘moderate’ participation rate, 50%, compared to other similar Scandinavian experiences. To illustrate the point, remember that the CP monitoring system activated by the Getafe University Hospital it has only 20% share. “
These findings have direct implications for the design and implementation of monitoring programs.
For Páez Borda, the present study addresses a central issue to all initiatives related to the early detection (or screening, which, essentially, is the same thing) of prostate cancer: epidemiologic research, that is, detection tumors that cannot be fatal. This situation, he told SMC, “is what makes universal prostate cancer screening impossible.” And avoiding the detection of this type of tumor will allow the benefits of screening – which exist, let’s not forget – to precede its negative effects. In this sense, MRI has the potential to act as a filter to avoid the diagnosis of indolent tumors, as long as a very strong diagnostic process is observed: among other words, in the present study all the images (more over 13,000 lessons). interpreted by a team of four radiologists with more than five years of experience in MRI. In addition, the studies were conducted using a three-Tesla resonator, a state-of-the-art device. Of the combination of dedicated radiologistin English words, and higher materials, is necessary to obtain comparative data.
The study addresses an issue central to all initiatives related to the early detection of prostate cancer: overdiagnosis
Research in ‘NEJM‘ shows that after a total follow-up of about four years, the diagnosis of indolent tumors – overdiagnosis – is reduced by more than 50% compared to the usual method, without a significant increase in the tumors that have no cure seen until today.
For Marcos-Gragera, an epidemiologist at the company Epidemiology and Cancer Registry Department of Girona of the Catalan Institute of Oncology Master Plan«The results of this clinical research take special importance in light of the findings published by Vaccarella S, et al. This new study shows a dramatic increase in prostate cancer cases in Europe since 1980, which is attributed to the widespread use of the PSA test. However, the lack of a consistent increase in mortality suggests the problem of overdiagnosis.
In his opinion, the results “show the potential of MRI to change the detection of prostate cancer.” By reducing diagnoses of clinically insignificant cancers, MRI offers a way to reduce the adverse effects of overdiagnosis associated with PSA screening. “These findings have direct implications for the design and implementation of population screening programs, which must be important for diagnostic accuracy and the reduction of unnecessary injuries.”
And to all this, Pérez Borda added, “it has not been proven conclusively that screening programs for prostate cancer save lives.” Is the effort justified? ¿European health systems are prepared to accept such an overload?
#MRI #prevents #diagnosis #prostate #cancer