He Doth Protest too Much

We commented on the recent article indicating the almost 80% increase in metastatic prostate cancer and the correlation, not yet a causation, with the ACA and the Government's attempt to control health care costs. Now a representative of one of the institutions which have focused on cancers comes out stating what seem obvious, correlation is not causation, but if it talks like a duck, looks like a duck and walks like a duck, well you get the idea.

The blog piece states:

“This study makes a dramatic claim about an issue all of us have been watching eagerly: namely, whether less PSA screening might lead to more advanced cancers. But the current analysis is far from adequate to answer that question sufficiently"

Well not quite. The article just reported the fact and made no causal claim.  Why the extreme protest? Political ties, funding? Should we follow the money? The author stated:

“We looked at a trend and we reported an observation, but we do not claim to have a causative link.”

Yep, that's all folks. No claim. The blog continues:

In addition, in this study, the rise they detected began before USPSTF guidelines for screening changed. There may or may not be a rise in the rates of metastatic disease; but because of a flawed analysis, this study does not answer that important question. “So why was this unusual study leading to calls? It’s a safe guess that a press release sent to reporters nationwide with a somewhat alarming headline was the reason.

Causative or correlative? The same question can be asked about the above conjecture.

What are the facts. First the USPSTF came out with a recommendation based upon flawed studies, the American and European,  which indicated that PSA testing did not impact mortality. Second the Task Force then stated that PSA testing had no value and should not be done. Third, many Internists, most of whom do not spend their days reading and understanding the literature here, just went along with the recommendation. After all, many of their patients would have to pay out of pocket. Fourth, multiple other recent studies have indicated the flaws in the prime studies as well as having demonstrated a rise in metastatic PCa.

So what should believe? Our own lying eyes or the government experts?

In today's environment, trust in Government experts has dwindled to near zero. All one has to do is look at the current political campaigns.