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Do Increased 5-Year Survival Rates in Prostate Cancer Indicate Better Outcomes?
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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To the Editor: Dr Welch and colleagues1 argue that, because of lead time bias, men diagnosed with prostate cancer might not be living longer and instead are only being diagnosed earlier. Increasing 5-year survival rates thus may not reflect reduced disease burden and should not be taken as evidence of improved prevention, screening, or therapy.
Other authors provide different perspectives. Merrill and Stephenson2 focus on the "era of prostate specific antigen [PSA] screening" since 1988. Incidence-based mortality rates increased and peaked in 1992 but then started to decline. They state that "The justification for widespread screening is that men will be diagnosed earlier such that the potential cure is improved because of treatment. . . . A shift from distant to nondistant disease and from high to low grade tumors should have noteworthy effects. . . . As we have shown, prostate cancer mortality began to decrease in 1992 for . . . [Full Text of this Article]
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