The Numbers behind the ProtecT Trial

By David Sampson

This week’s release of the first study comparing outcomes between surgery, radiation, and active surveillance got a lot of buzz. But even then, some pretty important details did not get as much coverage as they probably could, and maybe even should have.

Here’s a quick look at the numbers behind two major statistics you may have heard in the coverage of this important study.

1: Men assigned to active surveillance had twice the risk of cancer progression and spread compared to men who got immediate treatment.

This is why it’s important to know the difference between relative risk and absolute risk. Relative risk is in relation to some other thing (e.g.: a�?twice as likelya�?). Absolute risk is what the chances actually are (e.g.: 1 in 6).

So a�?twice the riska�? tells us something important, but not everything important. Absolute risk tells a more complete story.

Among those men who got immediate treatment, three out of 100 saw their cancers progress in ten years.

Among men under active surveillance, the rate was six out of 100.

So immediate treatment (surgery or radiation) did indeed result in half the risk. But the increase in a�?absolute riska�? was 3%, which helps put a�?twice the riska�? into perspective. Also, it’s a reminder that current treatment is not foolproof, and that some cancers progress despite our best efforts.

2: More than half of men undergoing active surveillance ended up receiving treatment anyway.

Based on this stat, it would be easy to say all of the men diagnosed with early-stage prostate cancer using PSA might as well have gotten treatment. But take a closer look at the numbers.

As it turns out, protectabout third of the men assigned to active surveillance decided with their doctors to undergo treatment anyway. And understandably. Imagine the anxiety of knowing there’s a cancer …read more

Source:: American Cancer Society