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Friday 22nd June 2018

Prostate screening reduces deaths

5th July 2010

Prostate cancer screening of men aged 50-65 can cut death rates from the disease by up to 50%, according to a recent study in Sweden.


Swedish scientists said however that their findings did not necessarily mean they were recommending nationwide screening programmes for men in that age group.

Nationwide cancer screening programmes, such as the mammography programmes currently under way in many developed countries, have been criticised for turning up tumours that would have caused the patient no real problems if they had gone undetected.

In the University of Gothenburg trial, 20,000 men were divided equally into a group that was offered prostate screening and a group that was not.

Using a test which picked up prostate-specific antigen (PSA), the participants were followed for 14 years after joining study.

PSA is currently the most widely used test for prostate cancer in countries that test for it.

The study found that death rates were cut almost by half in the screening group compared with the non-screening group, because men were being diagnosed and treated earlier than in the non-screening group.

Study lead author Jonas Hugosson said that PSA screening of older men could indeed result in a relevant reduction in cancer mortality.

Wealthier nations use cancer screening as a way of improving public health, but there are concerns about the emotional and financial cost of overdiagnosis.

Routine prostate screening of men in a large US study was found last year to have resulted in more than a million American men being diagnosed with tumours who might have suffered no ill effects from them and required no gruelling treatment regimes, had they gone undetected.

The study concluded that for every man whose life was saved by the screening programme, there were 20 who were diagnosed and treated unnecessarily.

The Swedish study was published in The Lancet, and concluded that 12 men needed to be diagnosed to save one life, a lower rate of overdiagnosis, but nonetheless significant.

Around 254,000 men die annually around the world from prostate cancer. Previous screening programmes, including that in the US, have relied on the assumption that early diagnosis and treatment is better than standing by and doing nothing.

However, treatments such as surgery, radiation or hormone therapy can cause serious side-effects such as impotence and incontinence, a concern that has put off many European countries from introducing such a programme.

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