Pros and cons of prostate cancer screening

sir – Saturday’s Telegraph contained two views on prostate cancer screening using prostate-specific antigen (PSA) blood testing.

Anthony Cross (Letters, January 18) was never offered a PSA test and now has prostate cancer. Meanwhile, Dr Margaret Mccartney (Comment, January 18) argues against screening.

I agree with Dr Mccartney that the evidence in favour of prostate cancer screening is not as strong as many of us would like. But a recent review of all the available research has shown that, among men aged 55-69, it may prevent between one and two deaths from prostate cancer per 1,000 men. Also, it does appear that annual PSA screening – and looking at trends – is much better than a one-off test.

Having been involved in research into the earlier diagnosis of cancer for many years, I think it is unlikely that we will ever achieve the level of evidence perfection that Dr Mccartney is seeking. Although some new tests and approaches are on the horizon, it will take years before results appear. In the meantime, men need better information about the positive and negative aspects of PSA screening. Each man then needs to decide where the balance lies between the pros and cons.

Dr Nick Summerton

Welton, East Yorkshire

sir – I am alive today largely due to the French health service, which carried out annual PSA checks on my brother, a French citizen.

When his PSA level rose significantly and further tests showed that he had prostate cancer, the doctors advised that any siblings should be checked, as the disease may be genetically inherited. Testing confirmed that I was affected, and luckily I was treatable.

As I had no symptoms and no access to annual tests here, it is likely that I would have been diagnosed too late. PSA testing may not be perfect, but it does provide an early indication when all is not well.

Rob Green

Braintree, Essex