Prostate cancer screenings don’t automatically save lives: Study

An alarming new study out of the UK has found that prostate-specific antigen (PSA) tests, the most common test used to detect prostate cancer in men, does little to prevent death from the disease. 

The University of Bristol study, published in the JAMA Journal, found that while PSA tests are an effective way of detecting cancers, they don’t actually reduce the number of prostate cancer deaths in the United Kingdom.

For their study, researchers analysed the effects of PSA testing on 400,000 men aged 50-69. They split the men into two groups of 200,000 and gave one group a singular PSA test, while the other group went without. After 10 years, they found the PSA test detected more instances of cancer, but had little effect on mortality rate.   

The study adds to the ongoing dialogue around over-detection and over-treatment of prostate cancer with some experts arguing it can be harmful.

Study author Professor Richard Martin told Starts at 60 that screenings with a one-off PSA test weren’t enough to save lives.

“A single, low-intensity PSA screen test still detects too many low-risk prostate cancers, while also missing cancers that do not need treatment,” he explained. “After an average 10-years of follow-up, the group who had been screened had the same percentage of men dying from prostate cancer as those who had not been screened. Men need to be told this, and new methods of testing need to be adopted and evaluated.”

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He suggested that many PSA tests weren’t always accurate in detecting cancer that has the potential to become deadly.

“The CAP trial adds to the evidence that screening men with PSA detects some disease that would be unlikely to cause any harm but also misses some aggressive prostate cancers that do need treatment,” he explained. “However, finding a way to improve the number of aggressive prostate cancers that get caught in time, whilst reducing the number of men who have screening, biopsies or treatments unnecessarily, remains important.”

Professor Martin explained that despite the findings surrounding PSA screening, research is still ongoing to evaluate how new technologies can pave the way for safer and effective screening policies in the future.

“Genetic tools may help to guide decisions of who to screen towards men at the highest risk of aggressive prostate cancer requiring treatment,” he said.

He also gave an insight of a new test called mpMRI that uses a powerful magnetic field, radio frequency pulses and a computer to provide a detailed image of the prostate to aid the detection of clinically significant prostate cancer.

Professor Martin said performing an MRI scan before a prostate biopsy has the potential to reduce the number of men with low-risk levels of the disease undergoing biopsies that aren’t necessary.

“Additional blood tests to predict future risk of prostate cancer or to screen for the presence of early disease are under investigation to improve the detection of prostate cancers requiring treatment,” he added.

Have you experienced prostate cancer, or know someone who has been diagnosed? Have you ever had a PSA test?