Medical Malpractice Myths
Sources: David A. Hyman, MD, JD ; and Charles Silver, JD; CHEST 2013; 143(1):222–227
Take it with a grain of salt as it comes from a physician-lawyer and a lawyer, but strongly consider a well-researched article published in a peer reviewed medical journal which seeks to dispel the 5 Major myths that are consistently brought up by advocates for tort reform.
Myth 1: Malpractice Crises Are Caused by Spikes in Malpractice Litigation (ie, Sudden Rises in Payouts or Claim Frequency)
So-called “runaway” jury verdicts are rare and payment on them rarer still. Using data from State and Federal databases, including the National Practioner Databank, the authors determined that the frequency of medical malpractice claims and medical malpractice payments on malpractice claims were either stable or declining in the years preceding the “medical malpractice crisis” 1999 to 2000. The vast majority of patients who have bad medical outcomes do not retain a lawyer and do not ever file a medical malpractice lawsuit.
Myth 2: The Tort System Delivers Jackpot Justice
Again, most medical malpractice cases are settled with less than 5% of medical malpractice cases going to trial. And the doctors tend to win, at least 75% of the time. The big verdicts get publicity because, well they are big verdicts. But the fact is that big verdicts aren’t typically paid verdicts. Appeals almost always follow and such cases, if not retried, are settled for substantially less money than the original reported verdict. Settlements are almost always on the condition of non-disclosure agreements and therefore these do not get published with the detail and names that the original sensational news item will.
Myth 3: Physicians Are One Malpractice Verdict Away From Bankruptcy
Any verdict, blockbuster or otherwise, that exceeds the limits of a provider’s insurance coverage (typically $500,000 to $1 million) is very unlikely to be paid. It certainly would be difficult if not impossible in some circumstances to collect a verdict directly from a doctor. Out-of-pocket payments by physicians are extraordinarily rare. In sum, physicians have effectively no personal exposure on malpractice claims (other than the obvious and unavoidable side effects of litigation, eg, the emotional and time-related costs of being deposed and the surcharges from their insurance company).
Myth 4: Physicians Move in Large Numbers to States That Adopt Damages Caps
The “we’re losing our doctors” cry has fallen on deaf ears. Your doctors are still here, for the most part. It is true that doctors are electing not to go into higher risk professions (obstetrics, surgery) and that this may be a response to medical malpractice claims but babies continue to be delivered at hospitals both with and without incident. According to the authors’ extensive research, those patients who suffered grave and permanent injuries (including death) received a mean payout of only $1.25 million and a median payout of about $1 million. Not the kind of thing that causes doctors to leave en mas
Myth 5: Tort Reform Will Lower Health-care Spending Dramatically
The direct costs of medical malpractice claims (including the cost of malpractice awards and settlements and all costs associated with defending against such claims, including the administrative costs of medical malpractice insurers is relatively modest. There is broad agreement that the direct costs of the malpractice system are on the order of 2% of health-care spending. Studies, commissioned by the Federal Government suggest that a cap on non-economic damages would reduce Medicare spending by a statistically insignificant 1.6%.
Damages caps do little to improve the malpractice system. Although they can dramatically reduce claims frequency, payouts per claim, and insurance premiums, they do not make health-care safer, reduce health-care spending, compensate those who are negligently injured, or make the liability system work better. The best reforms are patient safety initiatives that reduce the frequency and severity of medical mistakes. Those tend to come from medical malpractice lawsuits.
The Lewis Law Firm handles cases of medical malpractice in Philadelphia and New Jersey. Call for FREE consultation today. Have you or a loved one been the victim of medical maplractice? Contact the Lewis Law Firm for a free consultation.
Nursing Malpractice in patient handoffs
A study from the University of Maryland in Baltimore sheds light on a common nursing practice in hospital and surgical settings, which you might not be aware of -patient handoffs. Patient handoffs (“taking report”) occur when nursing staff changes shift, from am to pm or when a patient is transported to or from an operating room to a particular floor or unit of the hospital. Handoffs are nursing communication which can range from the patient’s latest vital signs to areas of particular concern or changes during a particular shift or prior to a transfer. Handoffs may take place at a nursing station or at a patient’s bedside. It was once a common practice to simply discuss a particular patient anywhere within the hospital, which is why you see signs in hospital elevators reminding staff not to discuss patients.Among their conclusions were that, “Handoffs can create important information gaps, omissions and errors in patient care.”
The study’s authors recommend computerization of handoffs as a way to prevent errors that may constitute nursing malpractice and which may result in harm to a patient. Verbal handoffs (where nurses communicate with one another regarding patients when transferring shifts) serve important functions beyond information transfer and should be retained. A Greater consideration was felt to be needed on analysing handoffs from a patient-centered perspective (oddly, we assumed this was always the perspective nurses took when attending to patients). The study suggested that handoff methods should be highly tailored to nurses and their contextual needs. The current preference for bedside handoffs (where a nurse changing shift discusses the patient at bedside, in front of the patient) is not supported.
The specific handoff structure for all units may be less important than having a structure for contextually based handoffs. Research on pertinent information content for contextually based handoffs is an urgent need. Without it, handoff computerization is not likely to be successful. Researchers need to use more sophisticated experimental research designs, control for individual and unit differences and improve sampling frames.
The Lewis Law Firm handles cases of nursing malpractice and hospital malpractice in Philadelphia and New Jersey. Call for FREE consultation today. Have you or a loved one been the victim of nursing or hospital malpractice? Contact the Lewis Law Firm for a free consultation.
Cancer Misdiagnosis Common
Sources: Best Doctors and the National Coalition on Health Care Joint Study; American Journal of Medicine; BMJ Quality and Saftey
Cancer is diagnosed more commonly than most physicians, themselves are aware. A series of recently published studies indicate a misdiagnosis rate from 15% to 28% of the time. There are a number of reasons cited by medical professionals for this seemingly high rate of misdiagnosis for cancer: Among these are: fragmented medical records; time-strapped doctors simply not having enough time with patients; errors in pathology interpretation; patients not knowing or sharing important pieces of their family medical history; and an inflexible adherence to protocols. In addition to the number of lost and damaged lives, there are considerable financial costs associated with a high misdiagnosis rate. $700 Billion dollars are estimated to be wasted by the US Medical System each year– countless billions of which are from diagnostic error.
Over 1.6 million new cancer cases in the U.S. are projected to occur in 2013, according to the American Cancer Society. Some 400 pathologists, medical oncologists and surgical oncologists were polled to determine their awareness of the relative rate of cancer misdiagnosis. When participating doctors were asked how often they would estimate misdiagnoses rates in oncology, the majority (60.5%) estimated 0 to 10% of the time. Only 4.8% believed misdiagnoses occur 20-30% of the time. These numbers counter published studies which show misdiagnosis rates in general reaching up to 28%, and up to 44% for some types of cancer, according to the Journal of Clinical Oncology. This lack of physician awareness is also concerning.
When asked what types of cancer conditions physicians believe are most often misdiagnosed or mischaracterized, 21 conditions were named. Leading the top five misdiagnosed cancer conditions by a considerable margin was Lymphoma, followed by Breast Cancer, Sarcomas and Melanoma.
Does this mean that all cancer misdiagnosis is the result of medical malpractice by a physician? No. However the number is too large to attribute the rate of misdiagnosis to exemplary medical care in all circumstances. So what does this mean for you, the patient? Be your own health care advocate. Insist on follow up testing if you feel that something is being treated lightly or may be overlooked. If physicians who specialize in the recognition and treatment of cancer are unaware of how frequently it is misdiagnosed, they might not be so quick to find it.
The Lewis Law Firm has a history of representing women who are diagnosed late with breast cancer. If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with breast cancer contact the Lewis Law firm today for a FREE consultation.
Hospital Infections. No Big Improvements.
Source: US Dept. of Health & Human Services, Agency for Healthcare Research and Quality Press Release
Hospital infections persist, according to the recently issued National Healthcare Quality Report and National Healthcare Disparities Report by the U.S. Department of Health & Human Services’ Agency for Healthcare Research and Quality to the conclusion that improvements in patient safety continue to lag.
Very little progress has been made on eliminating hospital infections (hospital-associated-infections) or (HAIs), according to a new section added to the quality report. For example, of the five types of hospital infections in adult patients who are tracked in the reports:
- Rates of postoperative sepsis, or bloodstream infections, increased by 8 percent.
- Postoperative catheter-associated urinary tract infections increased by 3.6 percent.
- Rates of selected infections due to medical care increased by 1.6 percent.
- There was no change in the number of bloodstream infections associated with central venous catheter placements, which are tubes placed in a large vein in the patient’s neck, chest, or groin to give medication or fluids or to collect blood samples.
- However, rates of postoperative pneumonia improved by 12 percent.
In addition, although rate of hospital infections could improve incrementally, blacks, Hispanics, Asians, and American Indians are less likely than whites to receive preventive antibiotics before surgery in a timely manner.
“Despite promising improvements in a few areas of health care, we are not achieving the more substantial strides that are needed to address persistent gaps in quality and access,” said AHRQ Director Carolyn M. Clancy, M.D. “Targeted AHRQ-funded research in Michigan has shown that infection rates of HAIs can be radically reduced. We are now working to make sure that happens in all hospitals.”
Over 100 participating hospital intensive care units in Michigan have been able to keep the rates of central line-associated bloodstream infections to near zero, 3 years after adopting standardized procedures. The project, conducted by the Michigan Health and Hospital Association Keystone Center, involved the use of a comprehensive unit-based safety program to reduce these potentially lethal infections. Last year, AHRQ announced new funding that has expanded the project to all 50 states, Puerto Rico, and the District of Columbia.
AHRQ’s annual quality and disparities reports, which are mandated by Congress, were first published in 2003. The reports show trends by measuring health care quality for the nation using a group of credible core measures. The data are based on more than 200 health care measures categorized in four areas of quality: effectiveness, patient safety, timeliness, and patient-centeredness.
The reports indicate that the lack of health insurance slows improvement in health care quality and reduction of disparities. For many services, not having insurance is the single strongest predictor of poor quality care, exceeding the effects of race, ethnicity, income or education.
Americans with no insurance are much less likely than those with private insurance to obtain recommended care, especially preventive services and management for diabetes. While differences between blacks and whites in the rates of lack of insurance have narrowed in the past decade, disparities related to ethnicity, income and education remain large.
The Lewis Law Firm handles cases of hospital infection and hospital malpractice in Philadelphia and New Jersey . Call for FREE consultation today. Have you or a loved one been the victim of hospital maplractice? Contact the Lewis Law Firm for a free consultation.
Advanced Breast Cancer Increase in Women under 40
Sources: JAMA (Journal of the American Medical Association) 2013;309(8):800-805; National Cancer Institute, SEER Cancer Statistics Review
ADVANCED breast cancer, or metastatic breast cancer (spread through the body) effectively tripled among women younger than 40 between 1976 and 2009. These are women whose cancer had already spread by the time it was diagnosed. In this small, but statistically significant trent, 800 women between age 25 and 39 are now being diagnosed with advanced cancer as compared with 250 a year in the mid-1970s.
Researchers analyzing trends in cancer rates have published their findings in a recent issue of JAMA. Among the more troubling things they found were: that the rate of cancer incidence has gone up fastest in younger women — ages 25 to 34; and, that the trend affects women of all ethnic backgrounds, in rural areas as well as cities, and it has been accelerating in recent years. Because young age itself is an independent adverse prognostic factor for breast cancer, and the lowest 5-year breast cancer survival rates as a function of age have been reported for 20- to 34-year-old women. The most recent national 5-year survival for distant disease for 25- to 39-year-old women is only 31% according to SEER data, compared with a 5-year survival rate of 87% for women with locoregional (non-metastatic) breast cancer.
Breast cancer is the most common malignant tumor in US adolescent and young adult women 15 to 39 years of age, accounting for 14 percent of all cancer in the age group. The individual average risk of a woman developing breast cancer in the United States was 1 in 173 by the age of 40 years when assessed in 2008. Young women with breast cancer tend to experience more aggressive disease than older women and have lower survival rates.
Rebecca H. Johnson, M.D., of Seattle Children’s Hospital and University of Washington, Seattle, and colleagues conducted a study in which breast cancer incidence, incidence trends, and survival rates as a function of age and extent of disease at diagnosis were obtained from 3 U.S. National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) registries. These registries provide data spanning 1973-2009, 1992-2009, and 2000-2009. SEER defines localized as disease confined to the breast, regional to contiguous and adjacent organ spread (e.g., lymph nodes, chest wall), and distant disease to remote metastases (bone, brain, lung, etc).
Since 1976, there has been a steady increase in the incidence of distant disease breast cancer in 25- to 39-year-old women, from 1.53 per 100,000 in 1976 to 2.90 per 100,000 in 2009. The researchers note that this is an absolute difference of 1.37 per 100,000, representing an average compounded increase of 2.07 percent per year over the 34-year interval. And the trend shows no signs of stopping.
The researchers also found that the rate of increasing incidence of distant disease was inversely proportional to age at diagnosis. The greatest increase occurred in 25- to 34-year-old women. Progressively smaller increases occurred in older women by 5-year age intervals and no statistically significant incidence increase occurred in any group 55 years or older. Incidence for women with estrogen receptor-positive subtypes increased more than for women with estrogen receptor-negative sub-types.
The Lewis Law Firm has a history of representing women who are diagnosed with advanced breast cancer. If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with breast cancer contact the Lewis Law firm today for a FREE consultation.
Childhood Disease Rates Rise
Sources: U.S. Center for Disease Control and Prevention; National Institutes of Health
Childhood Disease Rates have been kept low with the advent of vaccination programs. Childhood disease is common in the early months and years of life. Some upper respiratory viral or bacterial infections—colds, bronchitis, or croup—are quite common. Also common are ear infections, sinusitis, impetigo (skin infection), and conjunctivitis (pinkeye). However, there are diseases which used to kill large numbers of children before they reached adulthood. Vaccines have been incredibly effective in preventing childhood diseases and improving child mortality rates.
Childhood diseases such as Diphtheria lead to breathing problems. Pertussis is another name for whooping cough, and it hinders breathing and eating. Tetanus is a serious bacterial infection that can be fatal if not prevented or treated. Vaccinating your child against diphtheria, tetanus, and pertussis can be done in a single dose (DTP Vaccine). Thanks to a vaccine, the United States is one of the only places in the world where polio is completely eradicated. One shot is all it takes to prevent this paralyzing condition. Getting a flu shot and a pneumonia vaccine are also recommended for infants six months or over. A certain strain of pneumonia can lead to blood infections and meningitis, which is covered in the vaccine. Similarly, the MMR vaccine protects against measles, mumps, and rubella, viral infections that cause serious symptoms. Measles and mumps often can lead to chronic conditions, such as deafness, brain damage, and reproductive problems. Rubella (also known as the German measles) and causes a high fever.
Why?
The childhood diseases of Pertussis and Measles have been seen more frequently than expected in the United States as parents “opt out” of vaccination programs because of misplaced fears regarding the safety of vaccines. More than 41,000 cases of pertussis were reported to CDC during 2012. 18 pertussis-related deaths during 2012 were been reported to CDC as of January 5, 2013. The majority of deaths continue to occur among infants younger than 3 months of age. The incidence rate of pertussis among infants exceeds that of all other age groups. The second highest rates of disease are observed among children 7 through 10 years old. Rates are also increased in adolescents 13 and 14 years of age.
The CDC reports several important milestones already have been reached in controlling vaccine-preventable diseases among infants and adults worldwide. Vaccines have drastically reduced infant death and disability caused by preventable diseases in the United States. In addition:
- Through immunization, we can now protect infants and children from 14 vaccine-preventable diseases before age two.
- In the 1950s, nearly every child developed measles, and unfortunately, some even died from this serious disease. Today, few physicians just out of medical school will ever see a case of measles during their careers.
- In March 2005, CDC announced that rubella is no longer a major health threat to expectant mothers and their unborn children, thanks to a safe and effective vaccine, high vaccine coverage.
- In September 2010, CDC announced that childhood immunization rates for vaccines routinely recommended for children remain at or near record highs.
- Yet, the CDC reports, “without diligent efforts to maintain immunization programs in the United States and to strengthen them worldwide, vaccine-preventable diseases will remain a threat to children. As illustrations, it’s only necessary to consider the 2010 California outbreak of whooping cough where over 8,000 cases were reported in the state and where there were 10 infant deaths, or measles, which takes the lives of more than 100,000 children globally each year.”
- Over the last two years, Pennsylvania has had one of the highest rates of pertussis outbreaks in the US.
For more information search for “childhood immunization” or “shots” on medlineplus.gov. Or visit the Centers for Disease Control and Prevention at www.cdc.gov/vaccines for more about vaccination schedules.
The Lewis Law Firm has a long history of representing children, and their families in Philadelphia and New Jersey. If your child has been diagnosed with preventable childhood disease, contact the Lewis Law Firm for a FREE consultation and review of your case, today.
Early Detection Critical for Breast Cancer!
Sources: American Cancer Society; and 30+ years of medical malpractice experience
EARLY detection of breast cancer, before it causes symptoms, is the key to cure and long-term survival of this disease. The goal of screening exams for early breast cancer detection is to find cancers before they start to cause symptoms. Breast cancers that are found because they are causing symptoms tend to be larger and are more likely to have already spread (metastasized) beyond the breast.
Although not all will admit this when they are Defendants in a medical malpractice case, most doctors believe that early detection tests for breast cancer save thousands of lives each year and that the size of a breast cancer when it is found and how far it has spread, and genetics, are the most important factors in predicting the prognosis (outlook) of a woman with this disease.
What are the risk factors for breast cancer? Many women with breast cancer have no apparent risk factors. There are breast cancer risk factors you cannot change. Among these are: Gender, men can develop breast cancer, but this disease is about 100x more common in women; Aging, your risk of developing breast cancer increases as you get older; Genetics, 5% to 10% of breast cancer cases are caused directly from genes BRCA1 and BRCA2; Family history of breast cancer, having a first-degree relative (mother, sister, or daughter) with breast cancer almost doubles a woman’s risk. 85% women who get breast cancer do not have a family history for it; Personal history of breast cancer, a woman with cancer in one breast has a 3- to 4-fold increased risk of developing a new cancer in the other breast (contralateral) or in another part of the same breast; Race and Ethnicity, white women are slightly more likely to develop breast cancer than are African-American women, but African-American women are more likely to die of this cancer; Dense breast tissue, women with dense breasts have a higher risk of breast cancer; Menstrual periods, women who started menstruating early (before age 12) and/or went through menopause later (after age 55) have a slightly higher risk of breast cancer; Previous chest radiation, treatment for hodgkin’s disease or lymphoma increases the risk of breast cancer as does chemotherapy.
What are the Signs and symptoms of breast cancer? The most common symptom of breast cancer is a new lump (mass). A mass that is painless, hard, and has irregular edges is more likely to be cancerous, but breast cancerscan be tender, soft, or rounded. They can even be painful. For this reason, it is important to have any new mass, lump, or breast change checked by your doctor and possibly by a breast surgeon. Other signs are: Swelling of the breast; Skin irritation or dimpling of the breast; Nipple pain or retraction (turning inward); Redness or scaliness of the breast; and, discharge. The American Cancer Society recommends that women age 40 and older should have a mammogram every year.
The Lewis Law Firm has a history of representing women who are diagnosed late with breast cancer. If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with breast cancer contact the Lewis Law firm today for a FREE consultation.
Neoadjuvant Therapy for Breast Cancer -Treating Before Treatment.
Sources: National Cancer Institute; Journal of Clinical Oncology; Lancet
NEOADJUVANT therapy is treatment given before primary therapy. For example, a woman may receive neoadjuvant chemotherapy for breast cancer to shrink a tumor that is inoperable or a woman whose breast tumor can be removed by mastectomy may receive neoadjuvant therapy to shrink the tumor enough to allow breast-conserving surgery.
Adjuvant therapy, or additional treatment (ie. chemotherapy, radition) has long been advocated for women with breast cancer. This takes place after the primary treatment, be it surgical, chemical or radiological. Neoadjuvant chemotherapy is given in the same manner as adjuvant chemotherapy. If a tumor does not respond (shrink) or continues to grow or even spread (metastasize) during neoadjuvant chemotherapy, the doctor may stop treatment and try another type of chemotherapy or perform surgery instead, depending on the stage of the cancer.
Clinical trials are examining whether hormonal thereapies or traditional chemotherapy agents, such as Tamoxifen, are benefecial to women diagnosed with breast cancer and even to women -very young women (under age 40) in particular, who have not yet been diagnosed with breast cancer but have a strong family history or genes of significance. “It is extremely encouraging to know there is a very simple technique that can make a really big difference in terms of coming out the other end with no disease,” said Lori Redmer, former executive director of the Triple Negative Breast Cancer Foundation.
The majority of breast cancers are driven by one of three causes – the hormone estrogen, another hormone called progesterone, or a gene called human epidermal growth factor receptor 2 (HER2). Triple negative isn’t caused by any of these – and it isn’t helped by the many targeted drug treatments that have been developed to fight the other three causes. Triple-negative cancer is more likely to strike young women, they aren’t checking for cancer the way older women are, they aren’t getting regular mammograms, and they often don’t find the tumors until they are large and have spread.
Breast cancer is the second-leading cancer killer of women, after lung cancer. The American Cancer Society projects that 226,870 women will be diagnosed with breast cancer this year and that 39,510 will die of it. In the United States, 93 percent of women with Stage 1 breast cancer survive for at least five years, but this falls to 15 percent for women with stage 4 – the type that has metastasized (spread).
The Lewis Law Firm has a history of representing women who are diagnosed late with breast cancer. If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with breast cancer contact the Lewis Law firm today for a FREE consultation.
Hospital Malpractice and America’s Safest Hospitals -is yours on the list?
Sources: AARP, The Magazine, Story by Beth Howard; the Leapfrog Group
By Gayle R. Lewis, Esquire:
Hospital malpractice continues to be a major health concern. The Leapfrog Group is an independent, national not-for-profit organization “founded more than a decade ago by the nation’s leading employers and private healthcare experts.” According to their website, “The Leapfrog Group Hospital Safety Score program grades hospitals on their overall performance in keeping patients safe from preventable harm and medical errors. The grades are derived from expert analysis of publicly available data using 26 evidence-based, national measures of hospital safety.”
Hospitals are given a Safety Score of A, B, C, D or F, depending upon their performance measures. More than 180,000 deaths from hospital errors resulting in injuries ocurr in US Hospital every year! Included are so-called “never events” such as bedsores and surgeries on the wrong part of the body as well as hospital acquired infections, medication mix-ups and other errors, some potentially fatal.
New Jersey ranks 15th out of the 51 states with 23 Hospitals scoring an “A” in the state. This only represents 33% of the state’s total hospitals, however. Pennsylvania ranks 20th out of the 51 states with only 37 of Hospitals in the state scoring “A”. This representes only 29% of all Hospitals in Pennsylvania. In New Jersey, the Cooper and Kennedy Health Systems and Jersey Shore Memorial Hospital come in with C’s while Our Lady of Lourdes brings in a D grade on the survey. In Philadelphia, the Temple and Thomas Jefferson Health Systems also score C’s. Temple University Hospital’s score reflects 131 deaths from “serious treatable complications after surgery.” Lourdes had 156 deaths in the same category.
While the survey organization has a lot of qualifiers to the use of its data, this is another free consumer tool out there to assist patients in determining where or whether they should go to a particular hospital in Philadelphia or New Jersey.
The Lewis Law Firm handles cases of hospital malpractice in Philadelphia and New Jersey . Call for FREE consultation today. Have you or a loved one been the victim of hospital or physician maplractice? Contact the Lewis Law Firm for a free consultation.
PSA Testing for Prostate Cancer
By: Gayle R. Lewis, Esquire
Sources: British Medical Journal 2013;346:f2023; BBC Health News
A STUDY initiated by Sweedish researchers was recently published in the British Medical Joural. The goal of the study was to determine the association (if any) between concentration of prostate specific antigen (PSA) at age 40-55 and subsequent risk of prostate cancer metastasis (spread) and mortality (death) in an unscreened population to evaluate when to start screening for prostate cancer and whether rescreening could be risk stratified.
The resarchers conclude that PSA concentrations can indicate not only the current risk of cancer—and hence the need for prostate biopsy—but are also predictive of the future risk of prostate cancer metastasis and cancer specific death. They recommed screening on men at highest risk, with three lifetime PSA tests between the ages of 45 and 60 sufficient for at least half of the male population. This is likely to reduce the risk of overdiagnosis while still enabling early cancer detection among those most likely to gain from early diagnosis. As such, a risk stratified approach to PSA screening will improve the ratio of its benefits and harms.
The Malmö Preventive Project in Sweden looked at a large study of 21 277 Swedish men aged 27-52 (74% of the eligible population) who provided blood at baseline in 1974-84, and 4922 men invited to provide a second sample six years later. Rates of PSA testing remained extremely low during median follow-up of 27 years.
Main outcome measures Metastasis or death from prostate cancer ascertained by review of case notes.
The risk of death from prostate cancer was associated with baseline PSA: 44% of deaths occurred in men with a PSA concentration in the highest 10th of the distribution of concentrations at age 45-49 (≥1.6 µg/L). Although a 25-30 year risk of prostate cancer metastasis could not be ruled out by concentrations below the median at age 45-49 (0.68 µg/L) or 51-55 (0.85 µg/L), the 15 year risk remained low at 0.09% at age 45-49 and 0.28% at age 51-55, suggesting that longer intervals between screening would be appropriate in this group.
The Lewis Law Firm handles cases of misdiagnosis and late diagnosis of prostate cancer in Philadelphia and New Jersey. Call for FREE consultation today. Serving NJ and PA. Have you or a loved one been diagnosed and treated for prostate cancer? Contact the Lewis Law Firm for a free consultation.