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Standard prostate cancer screen saves no lives, studies show
-MedPage Today_
Prostate cancer screening with prostate-specific antigen (PSA) afforded no obvious prostate cancer mortality benefit during 13 years of follow-up in a large randomized trial.
In fact, screened patients had a slightly higher prostate cancer mortality: 3.7 per 10,000 person-years, versus 3.4 for unscreened men.
The results emphasize the need to find some means to identify patients who are most likely to benefit from PSA screening, said the first author of a report in the January issue of the Journal of the National Cancer Institute.
“Routine mass screening of the population, purely on the basis of a man’s age, is not going to be an effective way of reducing his chance of dying of prostate cancer,” said Gerald Andriole, MD, of Washington University in St. Louis.
“Having said that, that’s not to say that no man should get PSA testing,” he continued. “There are subsets of men in the population at large who do seem to stand a good chance of benefiting from PSA testing.
“Those are men who are young, with no comorbidities, and generally very healthy. These are men with the longest life expectancy overall. They are men who, even if they harbor a nonaggressive, slow-growing cancer, are nonetheless expected to live long enough to die of prostate cancer in the absence of it being identified and treated.”
Screening also is reasonable for men who have an above-average risk of prostate cancer, such as African Americans and men with a strong family history of the disease, Andriole added.
