Prostate Cancer Screening Does Not Save Lives: New Study

[Guest fountainhall]

Ii a new study reported in the British Medical Journal, researchers in Sweden have concluded that prostate screening though digital examination or the commonly used PSA test (prostate specific antigen) has no benefits. The study was conducted in Sweden and involved 9,026 men in their 50s and 60s.

 

The report concludes: "After 20 years of follow-up, the rate of death from prostate cancer did not differ significantly between men in the screening group and those in the control group."

 

The favoured method of screening is the prostate specific antigen (PSA) test. However, around 15% of men with normal PSA levels will have prostate cancer and two-thirds of men with high levels of PSA do not in fact have prostate cancer . . .

 

Last year, the body which regulates screening in the UK advised against routine screening . . . "This evidence provides further support for the recommendation the Committee made in November not to screen for prostate cancer at this time . . .

 

Dr Sarah Cant, head of policy and campaigns for The Prostate Cancer Charity, said: "Whilst this research suggests that screening men for prostate cancer doesn't reduce the number of men dying from the disease, this was a relatively small study and not all the screening rounds used the PSA test, which is the most effective test we have at the moment to indicate prostate problems that might be cancer.

 

"We know from another larger study that screening using the PSA test can reduce mortality rates.

 

"However, this previous trial showed that screening can lead to many men undergoing unnecessary treatment for a harmless prostate cancer. The Prostate Cancer Charity therefore doesn't believe there is enough evidence yet to support a screening programme."

http://www.bbc.co.uk/news/health-12911174

[Rogie]

The confusion continues! It's a pity the PSA test hasn't lived up to its early hopes. I used to work in a lab and I well recall those hopes at the time (late 80's) when the PSA test replaced the older acid phosphatase blood test.

 

It doesn't mention this in the quote above, but almost always when we read a PSA article it says what is really needed is a way to be able to reliably distinguish between slow and fast growing prostate cancers. The slow-growing ones are often best left in peace, whereas the fast-growing need prompt treatment.

 

I still believe the PSA test is worth doing for men over 50. If you get it checked every few years then (assuming it is within normal limits) any significant increase over time is an indication for further testing. I don't think any responsible medical person would be able to interpret a one-off (random) result with much accuracy - if they tried it'd just be a guess, and guesses aren't good enough.

[Guest fountainhall]

I'll still have the PSA test included amongst the other tests when I go for a regular check-up, since it doesn't cost any more to have it done. I assume that any evidence of a fast growing tumour is more likely to show up with regular testing than a one-off.

[Rogie]

Later: I've re-read what I wrote earlier and it's a bit vague in places.

 

In my 3rd para I hasten to add when you reach 50 (just a convenient age, could be anywhere from 40 - 60, but not much after 60 I would suggest), get the test done (perhaps in a regular screening programme such as Fountainhall mentions) and assuming it is within normal limits the first time then any significant increase on future testing needs further examination, by which I mean a thorough discussion with your doctor about your health, digital rectal examination and possibly a biopsy to check for malignancy.

 

PS. I started to edit my original post as the 'edit' button was still operative. However, blow me if when I came to post the edited version I was told I had timed out and couldn't edit it. A bit annoying to say the least. My fault maybe for editing near the cut-off point but it would be better if once you start editing you are allowed time to finish the job. As Magnus Magnusson might have said, "I've started - I'm damn well going to finish!"

[Bob]

Could be wrong but it seems to me that an unexpected jump in your PSA reading is a solid clue there may be a problem. I've had 7-8 friends and one brother who had significant increases in their PSA level and all were later biopsied and determined to have cancer (and all are still with us after varied procedures).

 

I read somewhere that 50% of the boys in a family can expect to get this cancer if their dad had it. My dad had it (had his prostate removed at about age 75) and that's why I and my 7 brothers are rather religious about the annual PSA screen. The baby of the family had his prostate removed last year at age 47.

 

I'm continuing with the annual screening (PSA and the dreaded digital deal) unless/until they're sure it's a waste of time or until they come up with a better screening tool.