Yearly PSA screening highly effective for reducing prostate cancer deaths


Yearly PSA screening highly effective for reducing prostate cancer deaths

Dr. David Samadi provides his expert opinion on a recent retrospective cohort study concluding that men who have an annual PSA screening significantly reduce their risk of prostate cancer mortality.

A recent study of over 400,000 men under the age of 80 years found that prostate specific antigen (PSA) screening every 12 to 18 months decreased prostate cancer mortality and all-cause mortality risk by a significant 64% and 24% respectively, among men aged 55 to 74 years.

“This is encouraging news and serves as a reminder for all men age 40 and older to have an annual PSA screening,” exclaimed Dr. David Samadi.  “This study points out what I have always stressed to men.  Get screened, it can save your life.”

The 5-year research was conducted at Kaiser Permanente Northern California and recruited men aged 55 to 74. The study population was divided into 6 groups based on PSA testing intervals: 12 to 18, 18 to 24, 2 to 3 years, 4 to 9 years, and no prior PSA test. The men were also sorted into 7 age groups: younger than 50, 50 to54, 55 to 59, 60 to 64, 65 to 69, 70 to 74, and 75 to 79. Out of the 400,887 men, 8,542 had a biopsy-proven prostate cancer diagnosis during the study period from 1998 to 2002. Then there was a 12 to 16 follow-up, in which 770 men died from prostate cancer, 2512 died from other causes, and 5260 remained alive.

“What is unique and what I like about this study is that it focused on the different screening intervals and age groups,” stated Dr. Samadi. “Clearly it showed that the best time interval of choice is for men to be screened every year.”

The United State Preventative Services Task Force (USPSTF) released an updated prostate cancer screening guideline in May, 2018.  It recommended that men age 55 to 69 years should discuss with their doctor about PSA screening (USPSTF recommended against routine PSA screening for men aged 70 and older) and from there make their own decision.  This prompted the American Urological Association (AUA) to release a statement disagreeing with the recommendation for men 70 and older not to be screened annually for prostate cancer. AUA encourages men over 70 who are healthy to talk to their doctor about PSA screening as they could benefit from it.

“In my professional opinion, my recommendation still stands to begin PSA screening at age 40. Get a baseline screening at an early age, and from there, individualize and assess each man’s risk of prostate cancer for scheduling screenings,” explained Dr. Samadi. “Every man is different. If there are strong risk factors such as family history of prostate cancer or if they are African American that needs to be taken into consideration of the age and frequency of PSA screening.”

Two other studies also found that shorter screening intervals led to a greater reduction in prostate cancer mortality. One was the European Randomized Study of Screening for Prostate Cancer (ERSPC). Men in this study were screened every 4 years which showed a 21% decrease in prostate cancer mortality. But a 2-year screening interval from an analysis of the Goteborg subset of the ERSPC, found a 44% decrease in prostate cancer mortality.  

“There is obviously strength in saving men’s lives when PSA screenings are more frequent and regular,” said Dr. Samadi. “One other study agreeing with this is data from the National Cancer Institute which found that the death rate from prostate cancer was reduced by 51% from 1993 to 2014 when PSA screening was more common and widespread.”

Dr. Samadi went on to add, “The debate over when and how often to perform PSA screenings continues. My take is to be proactive at every step beginning with early screening to fight back prostate cancer. Why take the risk of not screening and missing men whose disease may have already metastasized complicating treatment and outcome.”

Patients newly diagnosed with prostate cancer can contact world renowned prostate cancer surgeon and urologic oncologist, Dr. David Samadi, for a free phone consultation and to learn more about prostate cancer risk, call 212-365-5000.