Prostate cancer deaths are not prevented by one-off PSA screening

Recently published in the Journal of the American Medical Association, researchers at the University of Bristol and the University of Oxford (both UK) have demonstrated that inviting men with no symptoms to a one-off prostate specific antigen (PSA) test for prostate cancer does not save lives.

The study, led by Richard Martin (University of Bristol), included approximately 600 GP practices in the UK with more than 400,000 men aged 50–69. The trial compared 189,386 men who were invited to have a one-off PSA test with 219,439 who were not invited for screening.

After an average of 10 years follow-up, there were 8054 (4.3%) prostate cancers in the screened group and 7853 (3.6%) cases in the control group. Crucially both groups had the same percentage of men dying from prostate cancer (0.29%).

The study also discovered that testing asymptomatic men with PSA, detects some disease that would be unlikely to cause any harm, but also misses some aggressive and lethal prostate cancers.

“Prostate cancer is the second most common cause of cancer death in men in the UK. We now need to find better ways of diagnosing aggressive prostate cancers that need to be treated early,” stated Emma Turner (University of Bristol).

Martin commented: “The results highlight the multitude of issues the PSA test raises – causing unnecessary anxiety and treatment by diagnosing prostate cancer in men who would never have been affected by it and failing to detect dangerous prostate cancers.  Cancer Research UK is funding work that will allow us to follow the men for at least a further 5 years to see whether there is any longer-term benefit on reducing prostate cancer deaths.”

“This trial illustrates that we need to develop more accurate tools if we want to save men’s lives. Cancer Research UK’s hunt for finding early stages of aggressive prostate cancer is not over. For example, we’re funding research into faulty genes which make some men more likely to develop prostate cancer and studying how these genes could help doctors to identify patients who are more at risk,” concluded Richard Roope (University of Manchester, UK).

Source: Cancer Research UK press release