Although men who undergo a PSA test do increase the possibility of their prostate cancer being detected, regular screening is not now thought to reduce the number of deaths which occur from the disease.
Milwaukee, WI -- (ReleaseWire) -- 02/13/2012 --Since 1986, when a reliable blood test first became available, hundreds of thousands of men have been screened for prostate cancer. The message was simple: find the cancer early, save your life. Now a long-running government study has a different message: finding cancer early will not save your life, in fact it may lead to unnecessary and painful treatments.
The current method of screening for prostate cancer is the PSA blood test, which measures a protein called the prostate-specific antigen, or PSA. Now the United States Preventive Services Task Force concludes that routine screenings are unnecessary. Behind this controversial conclusion lies a recent major study; the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial, recently published in the Journal of the National Cancer Institute.
Researchers studied prostate cancer screening in 76,000 men, aged from 55 to 74. The participants were randomly assigned to receive annual cancer screening. Six years of screening were performed with the PSA method and an additional four years of screening were done with a digital rectal exam. Those participants who were not assigned to receive annual screenings received standard care and were thus only screened if their doctor recommended it.
In the group of men who received annual screening, 12% more cases of prostate cancer were detected when compared to the group that received standard care. However, when it came to the number of actual deaths caused by prostate cancer, the two groups were comparable. In fact, there were slightly more deaths due to prostate cancer in the screening group than in the standard care group.
This has been interpreted to suggest that types of cancer generally discovered through annual screening are slow growing cancers in older men, who will generally die from other causes before the cancer becomes an immediate danger. Some critics of routine screenings go as far as to state that a diagnosis for these men may lead to a lesser quality of life as treatment often leave men stressed as well as impotent.
"I think it supports the recommendation that for the average man in the United States, mass screening is probably not beneficial at all," Dr. Gerald L. Andriole, the lead author of the study, said according to the New York Times, but there are many who disagree.
The European Randomized Trial of Screening for Prostate Cancer, the early results of which were published in 2009, discovered that death from prostate cancer was 20% lower in a group of screened men compared to the control group although the overall mortality rate remained the same.
Critics of Dr. Andriole's study also point out that almost half of the participants in the standard care group were recommended screening, which means that the study says little about screening in general. Additionally, men with a prostate cancer diagnosis often go on to live for 15 to 20 more years, whereas the study only followed the participants for 10 and 13 years.
But Dr. Andriole and his team of researchers are not saying that screening for prostate cancer is useless. Rather, they are saying that the average man may not benefit. Men with increased risk of prostate cancer, whether because close relatives have had advanced prostate cancer or because they belong to an ethnic group with increased risk, may still benefit from routine screenings.
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