Whether men should get tested for prostate cancer or not has been a longtime topic of debate, as science has been historically torn as to whether the screening process does more harm than good. However, a new study published this week in the Annals of Internal Medicine may influence men to go ahead with prostate specific antigen (PSA) testing, finding evidence it may reduce prostate cancer deaths by nearly one-third.
This latest research reanalyzed data from two previous large studies, one out of the United States, the Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Trial, and the other, the European Randomized Study of Screening for Prostate Cancer. Both large studies were published in 2009 in the New England Journal of Medicine, yielding contrasting results. The U.S. study found that testing men 55 to 74 didn’t make any difference in respect to prostate cancer deaths compared to those who were not screened, while the European study concluded that testing men 55 to 69 led to a 21 percent lessened risk of death from prostate cancer compared to those who didn’t undergo screening.
Because routine blood testing can lead to unnecessary and possibly harmful treatments (prostate cancer isn’t usually fatal, and tumors generally grow so slowly that radiation and surgery can often create more complications than they are worth), based on these studies, the U.S. Preventative Services Task Force (USPSTF) issued a recommendation in 2012 that the majority of men between the ages of 55 and 69 shouldn’t get a PSA after all, unless they were considered at high risk for the cancer. In April 2017 the same task force left the recommendation up to patients and their doctors.
But when researchers, some of whom were involved in the initial trials, went back and reassessed the data of both the U.S. and European studies, they came to the conclusion that getting a PSA test “can significantly reduce the risk for prostate cancer death” — by a whopping 25 to 32 percent — for men who fit the criteria for screening. The previous discrepancies between the two trials might be explained by the different methodologies and definitions used in the U.S. and European studies. Basically, the American study was comparing men who underwent PSA screening to those occasionally screened with the blood test, while the European study used a more pure control group of men who were not screened at all.
Based on these most recent findings, it is likely the guidelines on prostate cancer screening will be revised in the near future and more research will be conducted to determine the financial impact PSA testing will have on the health care industry.
But one thing is for sure: PSA testing can save lives if the results are appropriately assessed and treated. “The debate shouldn’t be to screen or not to screen, but how can we change screening so it does not cause harm,” Andrew Vickers of Memorial Sloan Kettering Cancer Center, who wrote an editorial accompanying the study, told the New York Times. “It’s not a take-it-or-leave-it. A PSA test can not really harm you or save your life. What can harm you is if the test leads you to get treatment you don’t need, and what can save your life is the PSA test that finds the cancer that could kill you.”
At the end of the day, make the best decision for you by talking to your doctor and being fully informed.
What's your take on this this?
Do you think PSA tests are necessary? Do you know anyone who has been diagnosed with prostate cancer? Were they treated appropriately?
