Die Vorsorgen der Anderen

Thomas Rösch plaudert mit Michael Bretthauer Thomas Rösch spricht mit Michael Bretthauer über seine neueste Analyse über die allgemeine Lebensverlängerung und die Evidenzgrad des kolorektalen Karzinomscreenings im Vergleich zu den Reihenuntersuchungen der anderen Fachrichtungen. Wie stehen “wir“ da? Gar nicht schlecht… Bretthauer M, Wieszczy P, Løberg M, Kaminski MF, Werner TF, Helsingen LM, Mori Y, Holme Ø, Adami HO, Kalager M. Estimated Lifetime Gained With Cancer Screening Tests: A Meta-Analysis of Randomized Clinical Trials. JAMA Intern Med. 2023 Aug 28:e233798. doi: 10.1001/jamainternmed.2023.3798. Zitat: “ The findings of this meta-analysis suggest that current evidence does not substantiate the claim that common cancer screening tests save lives by extending lifetime, except possibly for colorectal cancer screening with sigmoidoscopy.“ P. C. Gøtzsche and K. J. Jørgensen: Screening for breast cancer with mammography. Cochrane Database Syst Rev 2013 Vol. 2013 Issue 6 Pages Cd001877: Zitat: “Eight trials provided data. We classified three trials as adequately randomised (Canada PP, Malmö uptake 70-74% and UK age trial uptake 68%) and four as suboptimally randomized (Göteborg, New York, Stockholm, TwoCounty), as was also the extension of the Malmö trial, MMST II. One trial (Edinburgh) was not adequately randomised and cannot provide reliable data. The three adequately randomised trials did not find a statistically significant effect of screening on deaths ascribed to breast cancer, relative risk (RR) 0.93 (95% CI 0.79 to 1.09) aſter 7 years and RR 0.90 (95% CI 0.79 to 1.02) aſter 13 years. The four suboptimally randomised trials found a beneficial effect: RR 0.71 (95% CI 0.61 to 0.83) aſter 7 years and RR 0.75 (95% CI 0.67 to 0.83) aſter 13 years.” Richman IB, Long JB, Soulos PR, Wang SY, Gross CP.. Estimating Breast Cancer Overdiagnosis After Screening Mammography Among Older Women in the United States. Ann Intern Med. 2023 Sep;176(9):1172-1180. doi: 10.7326/M23-0133. Epub 2023 Aug 8. Zitat: “ Continued breast cancer screening was associated with greater incidence of breast cancer, suggesting overdiagnosis may be common among older women who are diagnosed with breast cancer after screening. Whether harms of overdiagnosis are balanced by benefits and for whom remains an important question.“ L. Peirson, D. Fitzpatrick-Lewis, D. Ciliska and R. Warren: Screening for cervical cancer: a systematic review and meta-analysis. Syst Rev 2013 Vol. 2 Pages 35 Zitat: “ The available evidence supports the conclusion that cervical screening does offer protective benefits and is associated with a reduction in the incidence of invasive cervical cancer and cervical cancer mortality.“ J. J. Fenton, M. S. Weyrich, S. Durbin, Y. Liu, H. Bang and J. Melnikow. Prostate-Specific Antigen-Based Screening for Prostate Cancer: Evidence Report and Systematic Review for the US Preventive Services Task Force. Jama 2018 Vol. 319 Issue 18 Pages 1914-1931 Zitat: “ PSA screening may reduce prostate cancer mortality risk but is associated with false-positive results, biopsy complications, and overdiagnosis. Compared with conservative approaches, active treatments for screen-detected prostate cancer have unclear effects on long-term survival but are associated with sexual and urinary difficulties.“ Hamdy FC, Donovan JL, Lane JA, Metcalfe C, Davis M, Turner EL, Martin RM, Young GJ, Walsh EI, Bryant RJ, Bollina P, Doble A, Doherty A, Gillatt D, Gnanapragasam V, Hughes O, Kockelbergh R, Kynaston H, Paul A, Paez E, Powell P, Rosario DJ, Rowe E, Mason M, Catto JWF, Peters TJ, Oxley J, Williams NJ, Staffurth J, Neal DE; ProtecT Study Group. Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. N Engl J Med. 2023 Apr 27;388(17):1547-1558. doi: 10.1056/NEJMoa2214122. Epub 2023 Mar 11.PMID: 36912538 Zitat: “After 15 years of follow-up, prostate cancer-specific mortality was low regardless