Large long-term study shows prostate cancer death reduced by PSA screenings


Large long-term study shows prostate cancer death reduced by PSA screenings

A Swedish study which followed 20,000 men for more than two decades found that men who had a prostate specific antigen (PSA) blood test, used to test markers of prostate cancer, slashes deaths from this disease by almost 30%.  This research is the longest screening study on prostate cancer to date.

PSA controversy

It has been questioned by prostate cancer authorities and still remans one of the most controversial topics among urologists of whether a PSA test should be conducted routinely.  What is known and is agreed on is that PSA testing does save lives.  The controversy involves whether it’s worth the risk to do routine screening which some urologists believe can lead to overdiagnosis and thus overtreatment of otherwise harmless cancers. 

Worldwide, most countries current guidelines suggest that PSA testing should not be offered by itself for diagnosing prostate cancer. This new study, however, shows the value of the long-term effects of an organized screening program in Sweden which challenge the current recommendation.

Findings from Swedish study

Based on data from the Randomized Population-Based Prostate Cancer Screening Trial, that included 20,000 men living in the city of Goteborg in 1994. The men in the study ranged in age from 50-64 years old and were randomly assigned to receive a PSA test every two years – along with a biopsy if PSA levels were elevated – or to a control group not offered PSA screening.

The findings from this study showed that after 22 years of follow-up, approximately 1,528 prostate cancers had been detected in screened participants, compared to 1,124 in the control group. Interestingly, the cancers in the screening group were found at an earlier stage, which led to a 29% reduction in prostate cancer deaths. In total, 112 screened men died from the disease, compared to 158 deaths in the control group.

Another finding was that three groups of men had a higher risk of death because of prostate cancer.  These men included those whose disease were detected during the first screening (all were over the age of 60); men diagnosed after leaving the study; and men who were invited to the screening group, but did not participate.

The men in the last group that did not participate (referred to as non-attenders), had a lower incidence of prostate cancer than attenders.  This was believed to be due to the fact most had asymptomatic, low-grade prostate cancer that were not detected, but were three times more likely to die of the condition.

Of the men who were diagnosed with prostate cancer after the study was done, were less likely to receive curative treatments.  The reasoning for this is likely because they were older and less likely to endure aggressive treatments. This points to the fact that PSA screenings should begin earlier in a man’s life.

PSA screening does save men’s lives when done routinely and when they begin at around age 40.  All men should discuss with their doctor of when to begin PSA testing and know of the signs and symptoms of prostate cancer.  When men become actively involved in the health of their prostate, the more men who can be saved from dying of prostate cancer.