Test No Guarantee to Save Lives

By Bob Groves

The most widely used test for detecting prostate cancer does not appear to save lives, researchers at the University of Medicine and Dentistry of New Jersey said Wednesday.

There was no evidence that routine screening for prostate specific antigen, or PSA, for the presence of cancer reduced the risk of dying from the disease, according to the study by the UMDNJ- School of Public Health and the UMDNJ-Robert Wood Johnson Medical School.

About 17 percent of men with prostate cancer will have an aggressive, life-threatening form of the disease, said Dr. Stephen Marcella, co-author of the study, published this month in the Journal of General Internal Medicine.

“Unfortunately, we still don’t have a reliable way of identifying the potentially lethal cancers” in patients without significant symptoms, said Marcella, an epidemiologist at UMDNJ.

The prostate is a chestnut-sized muscular gland that secretes seminal fluid.

PSA screening for prostate cancer, the second leading cause of cancer death among men, began being widely used in New Jersey in 1989.

The UMDNJ study compared medical records of 380 New Jersey men who died of prostate cancer between 1997 and 2000 with an equal number of survivors. About 25 percent of the men in both groups had at least one routine PSA screening, but there was no indication the tests led to a more timely diagnosis that saved lives.

Other large, ongoing randomized trials of PSA screening may find some benefits to the test in a couple of years, but “the value of the test for screening asymptomatic men is still unproven” for now, said Dr. George Rhoads, a UMDNJ epidemiologist and a co-author of the study.

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