Health News Review

The CBC Radio program, “White Coat, Black Art with Dr. Brian Goldman,” asked me to join them this week to discuss some issues surrounding journalists promoting cancer screening tests on network television.

Out of a 30 minute program, the segment with my interview appears between 10:22 and 20:30.  Note:  The audio begins automatically.  I don’t control that.  It’s the way the CBC’s embedded audio works.


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lisa lyn posted on November 25, 2013 at 2:06 pm

Great show but I very much disagree with the views about Movember. If ANYTHING gets men to pay attention to their health why are we complaining. Movember brings in millions of dollars and is used for numerous programs – including mental health issues. They are growing mustaches not promoting the ridiculous – sometimes degrading – fundraising techniques some are doing for breast cancer. I think the thing we are not focusing on is the word – baseline. I think EVERYONE after 40 should have a baseline test and, yes, that includes mammograms. I would rather have a false positive (because there should normally be secondary tests that would catch it – such as an ultrasound or needle biopsy) than have to argue with the physicians for several years about a false negative. When my Dr. finally ordered a biopsy I had a second stage invasive BC with positive nodes. Movember gets men talking about a subject they never would have dreamed to discuss a few years ago. Just my thoughts.

shaun nerbas posted on November 25, 2013 at 2:15 pm

Being a Canadian, I was just listening to CBC radio and you came on the show and discussed the limitations of various medical testing procedures. In my e-mail box was your regular letter, so I thought I would write and tell that I enjoyed your skeptical viewpoint, which brought some balance to the prostate segment I saw on the NBC morning show . I think NBC ‘s goal is to emulate and surpass the competition, ie, the popular ABC ( news/gossip ) morning program. Entertainment trumps facts, such as evidence based medicine, side effects, and limitations. I think CBS tries to stick to reporting the facts more than the other two American morning shows.

cecilia posted on November 26, 2013 at 5:07 am

@lisa Lyn. I have no thought about movember, but a lot about PSA screening.

First, it’s a VERY difficult medical discussion, that cannot be summarized in a few words, but even the american urological association gives these guidelines: (remember these are doctors that make money treating this cancer…)

-PSA screening in men under age 40 years is NOT recommended.

-Routine screening in men between ages 40 to 54 years at average risk is NOT recommended.

-For men ages 55 to 69 years, the decision to undergo PSA screening involves weighing the benefits of preventing prostate cancer mortality in 1 man for every 1,000 men screened over a decade against the known potential harms associated with screening and treatment. For this reason, shared decision-making is recommended for men age 55 to 69 years that are considering PSA screening, and proceeding based on patients’ values and preferences.

-To reduce the harms of screening, a routine screening interval of two years or more may be preferred over annual screening in those men who have participated in shared decision-making and decided on screening. As compared to annual screening, it is expected that screening intervals of two years preserve the majority of the benefits and reduce over diagnosis and false positives

-Routine PSA screening is not recommended in men over age 70 or any man with less than a 10-15 year life expectancy.

IF EVEN THE UROLOGISTS DON’T THINK everyone should be tested, I would look into the matter before forming an opinion.

usually the medical societies fight about these issues, in these case, they are not, so the evidence must be (and is, I have read it), really good!!)

also the term “harms of screening” must come into the conversation.
if a mas in operated ONLY based on psa lever, he faces at least incontinence and impotence, how about that for harm??, in a tumor that would probably NOT have grown at all!!

congratulation for the people of this blog, good work!!