Prostrate Screening Update: First, Do No Harm

On Jan 6th there was an update to the prostate cancer screening study showing that even with a longer follow up time, the screening is of extremely limited benefit. Given the nasty side effects of treatment, (outined below) the recommendation is not to screen with PSA. I've discussed this topic previously here, here, here

Prostate Cancer Screening Shows No Benefit

By TARA PARKER-POPE

Updated findings from one of the largest studies of prostate cancer screening show that the commonly used P.S.A. blood test did not save lives, although questions remain about whether younger men or those at very high risk for the disease might benefit.

Last fall, the United States Preventive Services Task Force concluded that healthy men should no longer be routinely screened for prostate cancer using the prostate-specific antigen, or P.S.A., blood test. That decision was based on findings from five well-controlled clinical trials, including a major American study called the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial, which studied P.S.A. testing in nearly 77,000 men ages 55 to 74...

Because prostate cancer can take several years to develop, the investigators continued to collect data after reporting the initial findings.

In a new paper published today in The Journal of the National Cancer Institute, the scientists report that the additional follow-up time didn’t change the overall conclusion: that regular P.S.A. testing does not save lives and can lead to aggressive treatments that leave men impotent, incontinent or both..

The findings suggest that the type of cancer typically detected by screening is so slow-growing that it often is unlikely to cause harm before the man dies of another cause...

“I think it supports the recommendation that for the average man in the United States, mass screening is probably not beneficial at all,’’ Dr. Andriole said. “It also will keep the discussion open about whether there are indeed subsets of men who do potentially stand to benefit from P.S.A. screening.”

What's old is new again. "The findings suggest that the type of cancer typically detected by screening is so slow-growing that it often is unlikely to cause harm before the man dies of another cause... This is what we were taught in medical centuries ago when I was a medical student.
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