We wholeheartedly welcome Adrian Masters' assertion that quality has to bind the Darzi recipe for reform through better and effective commissioning, but we are disappointed the director of strategy at Monitor should make misguided comments on survival rates of prostate cancer in the UK as compared with those in the US.
The survival difference quoted in the US figures is a mixture of length time bias and lead time bias, and has nothing to do with the dangers of "socialised medicine".
It is estimated 15-30 per cent of men over 50 in the UK have histological evidence of cancer in the prostate, rising to 60-70 per cent by the age of 80, but only one in 25 men will die from this disease. In other words, men are more likely to die with prostate cancer than from it.
To put this in a simple perspective, imagine in your town 20 people die every year from prostate cancer, out of 40 diagnosed. Survival is 50 per cent. Then you start screening for prostate cancer, and find you are diagnosing 80 cases every year, but still 20 die annually. The number of deaths remains unchanged but survival has now shot up to 75 per cent.
The Medical Journal of Australia (November 2007) emphasises that the incorrect information or data interpretation does not serve anyone well. We entirely subscribe to that view and are concerned that ill-informed statements will once again induce a rush for yet more unnecessary tests on the NHS.
Dr Ash Paul, medical director,Bedfordshire PCT, and Dr Robert Wilson, consultant in public health medicine, Lincolnshire PCT, on behalf of UK Commissioning Public Health Network
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