Regular Prostate Screenings Won't Reduce Cancer-Related Death Risk
January 7, 2012

Regular Prostate Screenings Won’t Reduce Cancer-Related Death Risk

Researchers from the Washington University School of Medicine in St. Louis claim to have discovered new evidence suggesting that obtaining an annual prostate cancer screening does not reduce mortality rate associated with the disease in older men.

The study, which was published online in the Journal of the National Cancer Institute (JNCI) on Friday, looked at approximately 76,000 men between the ages of 55 and 74 participating in the Prostate, Lung, Cancer, Colorectal and Ovarian (PLCO) Cancer Screening Trial.

Participants were randomly assigned to receive either annual Prostate-Specific Antigen (PSA) tests for six years and digital rectal exams for four years, or "routine care" that entailed only going for a screening if advised to do so by a doctor.

None of the subjects had any previous personal history of any of these four types of cancers prior to their participation in the study, which started in November 1993 and included follow-ups through December 2009, JNCI officials said in a January 6 press release.

Tumors were detected in 4,250 subjects who participated in the "intervention" arm (meaning that they went for the annual exams), while 3,815 tumors were detected in "control" group members (receiving their usual medical care, which may or may not have involved regular screenings).

However, according to a Washington University press release, "deaths from prostate cancer did not differ significantly between the groups. There were 158 deaths from prostate cancer in the screening group and 145 deaths in the routine-care group“¦ Annual screening tests also did not reduce deaths from prostate cancer among men in their 50s and 60s, as the researchers had hoped."

"The data confirm that for most men, it is not necessary to be screened annually for prostate cancer," lead author and principal investigator Gerald Andriole, the chief urologic surgeon at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, said in a statement. "A large majority of the cancers we found are slow-growing tumors that are unlikely to be deadly."

"Mass screening of all men on the basis of age alone is not the way to go, but screening can still be useful in select men," Andriole added.  "We have to take a more nuanced approach to determine which men should be screened with PSA in the first place, how frequently they should be tested, the PSA level at which they should be biopsied and whether their cancer warrants aggressive therapy."


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