Prostate cancer check – money is wasted
Mass prostate cancer screening does not reduce men's mortality
According to a study by scientists from the Washington University School of Medicine in St. Louis, USA, annual screening of men for prostate cancer increases the frequency of its detection, but does not reduce mortality, especially among men 50-60 years old. The results of a large-scale screening study for prostate, lung, rectum, colon and ovarian cancer (PLCO Cancer Screening Trial) are published in the Journal of the National Cancer Institute (Prostate Cancer Screening in the Randomized Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial: Mortality Results after 13 Years of Follow-up).
76 thousand men from the USA aged 55-74 years took part in the PLCO study. Half of them had passed the PSA test (prostate specific antigen test) annually for 6 years and underwent a thorough examination by a specialist, while the other half were under "routine supervision", i.e. patients were sent for examination only if their attending physician recommended it. Then the scientists observed the men for at least 10 years, and for the most part – 13 years. It turned out that men undergoing annual examination and screening for the development of prostate cancer, the disease is detected 12 percent more often (4250 cases versus 3815 cases in the "routine observation" group). However, the mortality rate from the disease does not differ much between the groups – 158 deaths in the annual screening group and 145 deaths in the "routine follow-up" group.
"Our data confirm that most men do not need annual prostate cancer screening," says study author Gerald Andriole, a urologist surgeon at the Siteman Cancer Center. "Screening is effective only among young men and has no benefit for men over 50-60 years old. We need to review existing diagnostic guidelines and screen only healthy men aged 40 years who have a family predisposition to prostate cancer or risk factors for its development. And if a 40-year-old man's PSA level turns out to be normal, there is no reason to subject him to further annual examination; most likely, he will not have prostate cancer."
The study was conducted a month after the publication of the American Preventive Services Task Force (U.S. Preventive Services Task Force) recommendations calling for an end to the annual screening for PSA of men aged 50 years and older. According to the group, this screening causes more harm than good, because with a positive test result, even with a small and slow-growing tumor, men often expect invasive biopsy and aggressive treatment.
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11.01.2012