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Saturday, December 31, 2011

Blog Updates for December 2011

This is the 5th year of publishing the Palpable Prostate!

Dec 26, 2011. We added to Bradford Hill Criteria of Causation (referring to bias in the medical literature): As another example this abstract [PMID: 22089952] discusses a high relative risk for rectal cancer after radiation treatment for prostate cancer but fails to give the fact that the absolute risk if very low (1% after 10 years of follow up based on a summary of the paper by Alan Brett published in Journal Watch General Medicine December 22, 2011). Evidently the authors belong to a department of surgery. Imagine how the same data might have led to different presentation and conclusions had the authors been radiation oncologists.

Dec 15, 2011. In USPSTF Draft Report we added: the "mammography controversy attracted congressional attention from legislators responding to constituents’ outrage and demanding greater transparency in the USPSTF decision making process. [Wall Street Journal Blog May 21, 2010]
We also added: The American Cancer Society is also moving to a system of generating guidelines that exclude specialists in the area from voting to eliminate conflict of interest (although input from them will be sought). See [WSJ Blog Dec 14, 2011] [PC Infolink blog Dec 16, 2011], JAMA article: [PMID: 22166609], Institute of Medicine [Clinical Practice Guidelines We Can Trust] and Institute of Medicine [Finding What Works in Health Care Standards].

Dec 12, 2011. In Biochemical PSA Recurrence we added: Well done, grilled or barbequed red meat may be harmful. A 2011 study of 470 cases and 512 controls found that "Higher consumption of any ground beef or processed meats were positively associated with aggressive prostate cancer, with ground beef showing the strongest association (OR?=?2.30, 95% CI:1.39-3.81; P-trend?=?0.002). This association primarily reflected intake of grilled or barbequed meat, with more well-done meat conferring a higher risk of aggressive prostate cancer. Comparing high and low consumptions of well/very well cooked ground beef to no consumption gave OR's of 2.04 (95% CI:1.41-2.96) and 1.51 (95% CI:1.06-2.14), respectively. In contrast, consumption of rare/medium cooked ground beef was not associated with aggressive prostate cancer." See [PMID: 22132129]

Dec 3, 2011. In USPSTF Draft Report we added: Further suspicion that the report is being commissioned to justify government health care rationing has been aroused by (1) the fact that the draft report was supposed to be issued for public comment but according to the same New York Times article the task force is not making the comments public indicating that "public comment" was intended to only mean "public input" and (2) according to the [boxed information on the USPSTF site] the USPSTF "lost" some of the public comments through a technical glitch.

Dec 1, 2011. In Biochemical PSA Recurrence we added: A study of "127,236 men of up to 75 years of age for whom relevant information was available in the SEER database, all of whom were treated by radical prostatectomy between 1988 and 2003" is summarized in this [PC Infolink] blog post and the abstract is available at [PMID: 22114813]. The annual hazard (roughly the probability of death in the following year given one is alive at the beginning of the year) was found to be 0.4%, 0.7% and 1% for 5, 10 and 15 years post radical prostatectomy with refined estimates based on risk groups as described in these links. Note that the hazard increases over this time span in contrast to other cancers where it typically decreases.

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