The authors' show that there is evidence of a reduction in mortality in only 30% of the disease-specific mortality estimates and 11% of the all-cause mortality estimates from the randomised controlled trials they evaluated.
Professor John Ioannidis, senior author on the paper, says: "Our comprehensive overview shows that documented reductions in disease-specific mortality in randomized trials of screening for major diseases are uncommon.
Moreover, future detailed population-based and translational studies may increase insight into causal factors of higher disease-specific mortality
and breast cancer relapse with increasing age," they added.
"We consistently found that surgery did not reduce [either all-cause or disease-specific] mortality for men with PSA levels less than or equal to 10, and we consistently found that radical prostatectomy reduced both overall and disease-specific mortality
in men with PSAs above 10," he said in the interview.
Three of these 5 studies reported a statistically significant benefit in disease-specific mortality
, but the all-cause mortality was either not affected or was worse.
Major Finding: Women with type 2 diabetes in the highest quintile of bran consumption had a 28% lower risk of all-cause mortality and 35% lower risk of cardiovascular disease-specific mortality
than women in the lowest quintile.
The new guideline recommends that PET scans also may be used "as part of initial staging in poorly differentiated thyroid cancers and invasive Hurthle cell carcinomas, especially those with other evidence of disease on imaging or because of elevated serum thyroglobulin levels; as a prognostic tool in patients with metastatic disease to identify those patients at highest risk of rapid disease progression and disease-specific mortality
; and as an evaluation of posttreatment response following systemic or local therapy of metastatic or locally invasive disease."
The retrospective study was described as the first to assess disease-specific mortality
risk in the era of prostate-specific antigen (PSA) screening.
One important finding was the observation that the reduction in disease-specific mortality
was greatest among patients younger than 65 years of age.
* For limited-stage prostate cancer, there is a lower rate of disease-specific mortality
and development of distant metastases with radical prostatectomy compared with watchful.