August 26, 2005

Screening spares men from advanced prostate cancer

NEW YORK (Reuters Health) - Among middle-aged and older
men, those who have had PSA tests are less likely to be found
to have prostate cancer that has spread to other sites in the
body, Canadian researchers report.

Dr. Jacek A. Kopec told Reuters Health, "There was a 35
percent reduction in risk among those who were screened."

Further, he added, "We observed a reduction in risk for
both men under 60 years of age and those 60 years or greater,
although the effect appears to be stronger in younger men."

Kopec, of the University of British Columbia, Vancouver,
and colleagues conducted a population-based study involving 236
cases of metastatic prostate cancer -- i.e., cancer that had
spread beyond the prostate. They were compared with 462 similar
men drawn from the metropolitan Toronto area who did not have
metastatic prostate cancer, although they could have localized
prostate cancer.

Based on the medical records, the rate of PSA screening was
significantly lower in men with advanced prostate cancer than
in the comparison group, the team reports in the August issue
of the Journal of Urology.

In those between 45 and 59 years of age, screening reduced
the odds of having metastatic cancer by 48 percent, and in men
between 60 and 84 years old, by 33 percent.

Kopec noted that the value of PSA screening is debated,
because it hasn't been shown to reduce mortality rates from
prostate cancer. "We believe our study contributes to this
debate in an important way," he said, "because it offers new
evidence that screening with PSA can reduce the risk of death
from prostate cancer -- the evidence is indirect as the outcome
we looked at was metastatic cancer rather than death."

In an accompanying editorial, Dr. Gerald L. Andriole of
Washington University School of Medicine, St. Louis, Missouri,
broadly agrees, pointing out that "few urologists would have
difficulty in accepting the notion that PSA screening results
in detection of prostate cancer before it becomes metastatic."

SOURCE: Journal of Urology, August 2005.