Routine prostate-specific antigen (#PSA) screening for prostate cancer does save lives: the updated results from the European Randomised study of Screening for Prostate Cancer (ERSPC) confirm that there is a substantial reduction in prostate cancer mortality attributable to PSA screening. The updated results were initially presented in April at the European Association of Urology 29th Annual Congress and have now been published in the Lancet. However, despite these findings, the authors remain cautious about population-based screening programs, because the high rate of screening-related overdiagnosis and overtreatment still needs to be addressed. There is no population-based PSA screening in Europe, although there has been widespread use of PSA for screening for prostate cancer in the United States. Further research is urgently needed on ways to reduce overdiagnosis, preferably by avoiding unnecessary biopsy procedures, and reducing the very large number of men who must be screened, biopsied, and treated to help only a few patients. At present, PSA screening is imperfect. Aside from detecting cancers that will never be life threatening or causing patients to undergo unnecessary treatment, they point out that an often-overlooked issue with screening is that it does not prevent all disease-related deaths. It is this trio of drawbacks (over detection, treatment complications, and disease progression) that leads to the uncertainty about the role of screening. In future publications from the study, the distribution of prostate cancer deaths by Gleason score and PSA at diagnosis will be important to understand how to tailor screening and treatment.
Posted on: Mon, 11 Aug 2014 04:59:56 +0000