MKT600 Integrated Case Analysis

There is much controversy about whether to screen for cancer of the prostate. In recent years editorials or reviews have been published in many journals discussing this. The New England Journal of Medicine, the British Medical Journal and the Medical Journal of Australia have all published discussion papers highlighting the problems of widespread screening for this disease and all came up with the same conclusions. As you read the article, consider the issues associated with introducing such a program. Please discuss in relation to the following points.

 

Judging appropriateness of using screening programs

 

The following questions need to be addressed in Vancouver Style referencing.

1. The condition being screened for should be an important health problem

2. The natural history should be well understood

3. There should be a detectable early stage

4. Treatment at an early stage should be of more benefit than at a later stage

5. There should be a suitable test for the early stage

6. The test should be acceptable

7. Intervals for repeating the test should be determined

8. There should be adequate health service provision for the extra clinical workload resulting from the screen

9. The risks, both physical and psychological, should be less than the benefits

10. The costs should be balanced against benefits

As it has been identified that the risk of prostate cancer is high for men, people are seeking for early diagnosis for the illness. Study has indicated that the cancer can be treated if detected at early stage (1). On the other hand, Australian Institute for Health and Welfare has been identified prostate cancer as the most prevalent cancer that has been diagnosed in Australia and 79 new cases of prostate cancer is diagnosed per 100000 male in the population (2).  Hence, prostate cancer has been identified as one of the major contributor to the morbidity and mortality rate of Australia. Therefore, it is required to introduce screening process in order to detect the illness at early stage. Prostate specific antigen and digital rectal examination have been found to be most common screening process in USA, however, the screening process is not included in the health policy of UK due to high health care cost. In addition, it has been reported that all the tumours identified by these screening process are not clinically relevant, hence, there is a doubt about the use of these screening process in the detection of prostate cancer at early stage (3). Hence, it is important to consider some factors before implementing any screening test for prostate cancer in Australia. The factors include, understanding of natural history of human physiology and the illness, introducing effective screening for early stage of prostate cancer that is acceptable for the people with diverse cultural background, introducing adequate treatment after ensuring the presence of cancer, intervals for repeating the test for confirmation, ensuring less physical and psychological risk for the patient and  most importantly the screening test needs to be cost effective so that it can be accessible and affordable for all (4). It would help the health department of Australia to introduce an effective screening technique and achieve expected health outcomes to minimize the risk of prostate cancer in the population.

References:

Wilt TJ, Harris RP, Qaseem A. Screening for cancer: advice for high-value care from the American College of Physicians. Annals of internal medicine. 2015 May 19; 162(10): 718-25.

gov.au (2018). Australia's health Overview - Australian Institute of Health and Welfare. Retrieved from https://www.aihw.gov.au/reports-statistics/health-welfare-overview/australias-health/overview

Malone P. Screening for prostate cancer: the case for. Annals of the Royal College of Surgeons of England. 2005 Mar;87(2):88.

Heidenreich A, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V, Mottet N, Schmid HP, van der Kwast T, Wiegel T, Zattoni F. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. European urology. 2011 Jan 1;59(1):61-71.