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Does Prostate Specific Antigen Screening Influence The Results Of Studies Of Tomatoes, Lycopene, And Prostate Cancer Risk? Dr Edward Giovannucci from Harvard Medical School published an editorial in the July 2007 issue of the Journal of the National Cancer Institute that responded to a report in the same issue from the FDA that stated that a "very low level of comfort" existed with tomato and tomato product consumption decreasing the risk of prostate cancer.

The essence of Dr. Giovannucci's argument that this conclusion may be flawed is that studies on lycopenes, tomatoes, and CaP risk are influenced by PSA screening. He focused on how PSA screening influences the diagnosis and epidemiology of CaP and when during prostate carcinogenesis this is a factor. Prior to PSA most CaP patients had advanced cancers at diagnosis. However, in the PSA era, many diagnosed prostate cancers are low risk and indolent and likely would not have been detected in the pre-PSA era. In the absence of PSA screening, the diagnosis of CaP follows a period of tumor proliferation that was stimulated by an internal or external factor. However, in the PSA era he argues, the diagnosis of CaP often signifies that a man just happened to have a PSA test.

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