PSA Screening Reduces Mortality From Prostate Cancer

A European study showed that prostate specific antigen (PSA) screening for prostate cancer could reduce deaths by 20%.

The study commenced in the early 1990s and involved men from eight countries--Belgium, Finland, France, Italy, Netherlands, Spain, Sweden and Switzerland--with an overall follow-up of up to 12 years. Participants totaled 182,000 but then narrowed down to 162,000 men in seven countries, aged 55-69; only those who had not been screened previously could participate in the study.

The men were initially screened with the prostate specific antigen (PSA) marker and offered regular follow up, which led to an increase in early detection. Deaths due to metastasized disease were reduced. Exact data showed that on average for every 1,408 men screened, 48 had cancer diagnosed and received treatment, resulting in saving one life. Screening took place on average every four years with a mean follow-up over nine years. The cut-off value was a PSA level of 3.0 ng/mL or more. Men with this reading were offered a biopsy.

Prof Fritz Schroder, international coordinator of the European Randomized Study of Screening for Prostate Cancer (ERSPC) study explained, "The study shows that PSA screening delivers a 20 % reduction in mortality from prostate cancer. This provides decision makers on screening policies with important new data on the effectiveness of PSA testing in preventing deaths. "

Separate ERSPC findings already confirm that approximately 30% of detected cancers actually have nonaggressive features and are 'indolent' or slow growing. With prostate cancer, a new, more conservative form of monitoring, "Active Surveillance,” might be an important method to help avoid early invasive treatment.

The study was reported online on 18 March 2009, by The New England Journal of Medicine (NEJM).

Related Links:
European Randomized Study of Screening for Prostate Cancer