Getting screened for prostate cancer was found to have the possibility of minimizing deaths by around a fifth, based on a major study that started in 1993 involving more than 162,000 men aged 50 to 74 years old from eight European countries.
The participating men from Belgium, France, Finland, Italy, Spain, Switzerland, Sweden and Netherlands received PSA screening every four years, except for Sweden that is two years, or no intervention at all for the control group. The men were also referred for biopsy if concentration of their PSA showed higher than 3.0 ng/ml.
Results of the long-term study, dubbed as European Randomised study of Screening for Prostate Cancer (ERSPC), indicated that prostate-specific antigen (PSA) screening could decrease deaths from prostate cancer by 15 percent in nine years and by 22 percent in 11 years.
In a 13-year follow-up, no further improvement was observed in the comparative decline in prostate cancer deaths that went down by about a fifth or 21 percent in the screening group as compared to the control group, though the men screened have a lesser chance of death from prostate cancer by 27 percent.
The complete benefit of PSA screening, however, gradually improved when follow-up is longer. The number of men required for researchers to invite for the screening in order to stop one death from the disease dramatically declined from 1,410 after follow up of nine years to 781 in 13 years, while those needed for diagnosis and treatment also dropped from 48 to 27. For the screening group, there was also smaller risk found for advanced prostate cancer.
"PSA screening delivers a substantial reduction in prostate cancer deaths, similar or greater than that reported in screening for breast cancer. However, over-diagnosis occurs in roughly 40% of cases detected by screening resulting in a high risk of overtreatment and common side-effects such as incontinence and impotence,” professor and study leader Fritz Schröder of Erasmus University Medical Center in Netherlands said in a statement.
He added that there is an urgent need to find ways to decrease over-diagnosis, preferably through evading pointless biopsy procedures as well as by lessening the number of men for screening, biopsy and treatment to assist only a few of the patients.
While the new evidence of PSA screening efficiency showed the possibility to minimize mortality rates, there are still doubts on whether the advantages outweigh the disadvantages. The authors concluded that routine-screening programs should not yet be introduced.
The Lancet journal published the study titled “Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up” in its August 2014 issue available online.
