PSA Test Might Not Save Lives

Study found screening for prostate cancer made no difference in survival rates

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MONDAY, Jan. 9, 2006 (HealthDay News) -- Screening men for prostate cancer with the prostate-specific antigen (PSA) test may not reduce their risk of death from the disease, new research suggests.

The finding appears in the Jan. 9 issue of the Archives of Internal Medicine.

Researchers looked at 501 men aged 50 and older who were diagnosed with prostate cancer between 1991 and 1995, and who had died by the end of 1999. They compared those men to a control group of 501 men diagnosed with prostate cancer who were still alive.

The study found that 14 percent of the men who died of prostate cancer and 13 percent of the men in the control group had been screened for prostate cancer with the prostate specific antigen (PSA) test. According to the researchers, if prostate cancer screening prevented death, fewer men who died would have received screening than those who were still alive.

The researchers, from the Veterans Affairs Connecticut Healthcare System and Yale University, also concluded that screening did not reduce prostate cancer death risk among men who were younger or healthier, or when digital rectal exams were used with PSA testing.

While screening can increase detection of prostate cancer, even at earlier stages, it doesn't necessarily prolong survival, the study authors concluded.

"Optimal clinical strategies for diagnosing and treating prostate cancer remain uncertain, and in need of additional investigation," the authors wrote. "Based on available evidence, including the present study, recommendations regarding screening for prostate cancer should not endorse routine testing of asymptomatic men to reduce mortality. Rather, the uncertainty of screening should be explained to patients in a process of 'verbal informed consent,' promoting informed decision-making."

The National Prostate Cancer Coalition called the study "invalid" because it didn't "take needed facts into consideration," such as the types of treatments offered the men.

"You need to look at what kind of treatments these men went through and change in PSA velocity over time," Dr. Richard N. Atkins, chief executive officer of the coalition, said in a prepared statement. "We're not examining genetically engineered mice where you have roughly the same DNA blueprint. These are men, and every man reacts differently to different treatments."

More information

The U.S. National Cancer Institute has more about prostate cancer screening.

SOURCE: JAMA/Archives journals, news release, Jan. 9, 2006


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