Prostate cancer screening may cause harm

Experts warn that PSA test could lead to overdiagnosis as trial shows one in six flagged cases wrong

PROSTATE cancer screening is likely to do more harm than good, experts have warned, after a 15-year trial showed one in six flagged cases was wrong.

The largest study to date investigating the PSA (Prostate-specific antigen) blood test, which is used as a screening tool in some European countries, found it had a small impact on reducing deaths, but also led to a worrying level of overdiagnosis.

In some cases, it missed early detection of some aggressive cancers.

Researchers from the universities of Bristol, Oxford and Cambridge, invited more than 400,000 men aged between 50-69 for screening, with just over half receiving a PSA test. After following up for 15 years, nearly seven men out of every 1,000 in the group invited for screening had died from prostate cancer, compared to nearly eight men out of every 1,000 who had not been tested.

‘Test results in some men going on to have invasive treatment that they don’t need’

The results of the trial show that an estimated one in six cancers found by the single PSA screening were overdiagnosed leading to unnecessary treatment of tumors that would not have caused any harm in someone’s lifetime

The treatment of prostate cancer may cause physical side effects including the possibility of infection following a biopsy, erectile dysfunction, and bladder and bowel problems.

Prof Richard Martin, lead author and Cancer Research UK scientist at the University of Bristol, said: “The key takeaway is that the small reduction in prostate cancer deaths by using the test to screen healthy men does not outweigh the potential harms.

“This results in some men going on to have invasive treatment that they don’t need, many years earlier than without screening, and the test is also failing to spot some cancers that do need to be treated.”

The UK National Screening Committee, which reviews the evidence for screening programmes, does not currently recommend screening for prostate cancer because it is unclear that the benefits outweigh the harms.

Dr Neil Smith, GP for Cancer Research UK and GP Lead for Lanca

‘Research highlights that a PSA test for early detection... [is] simply not accurate enough’

shire and South Cumbria Cancer Alliance, said: “This research highlights that a PSA test for early detection can do more harm than good – it’s simply not accurate enough.”

Dr Matthew Hobbs, Director of Research at Prostate Cancer UK, said: “A previous trial showed that screening with PSA blood tests does reduce deaths from prostate cancer but that it also misses important cancers and harms men who are given treatments or biopsies they don’t need.

“The results from the UK CaP trial are extremely significant, because they back up these findings.”