Risk Factors for Prostate Cancer May Be Influenced by Biopsy Bias, Researchers Say

Risk Factors for Prostate Cancer May Be Influenced by Biopsy Bias, Researchers Say
Risk factors for prostate cancer may not be what researchers believed. According to a study published recently in the Journal of Clinical Oncology, biases exist in screening and biopsy patterns, and those biases strongly influence the assessment of prostate cancer risk factors. The study, "Biases in Recommendations for and Acceptance of Prostate Biopsy Significantly Affect Assessment of Prostate Cancer Risk Factors: Results From Two Large Randomized Clinical Trials," suggests that risk factors derived from epidemiologic studies, where not all participants are equally likely to undergo screening, may be erroneous and lead to misdirected research efforts. Prostate cancer is the second most common cause of cancer death in men, and efforts that aim to control it include prevention, screening and improved treatment. Usually, prostate cancer prevention and early detection rely on the assessment of a patient's risk to determine how often he should undergo PSA screening or a prostate biopsy. But such risk factors are identified in epidemiologic studies and implemented in the clinic without confirmatory clinical trials. As a result, researchers in this study learned that even risk factors that are not associated with prostate cancer will be found to increase cancer risk. That is because men with the risk factor are more likely to undergo screening and be diagnosed with prostate cancer. "We assumed that prostate cancers are diagnosed uniformly, but that's not true," Catherine Tangen, DrPH, of the Fred Hutchinson Cancer Research Center, and the lead
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