Prostate-Cancer Screening Reduces Deaths by 50%

By Kristen Hallam - Jun 30, 2010



A blood test for prostate cancer helped reduce deaths from the disease by almost 50 percent after 14 years in a study, though overall mortality barely changed as patients died of other causes.

Of 10,000 men invited for the screening every two years, 44 died of prostate cancer, compared with 78 of 10,000 men who weren’t offered the test, according to researchers at the University of Gothenburg in Sweden. Total deaths were almost identical, at 1,981 in the screening group compared with 1,982.

The researchers said 293 men need to be screened and 12 diagnosed with prostate cancer to save one from dying of the disease. The finding may influence doctors’ debate over whether there’s too much screening and treatment of prostate cancer.

“Most of us feel better overtreating than undertreating,” Elizabeth Kavaler, an urologist at Lenox Hill Hospital in New York, who wasn’t involved in the research, said in an e-mail. “This study supports that approach.”

The prostate-cancer tests reduced deaths from the disease more than comparable screening has done for breast cancer and colorectal cancer, according to the study. The results from the research, which is continuing, were published online today in Lancet Oncology.

In the study, 11.4 percent of men in the screening group and 7.2 percent in the control group were diagnosed with prostate cancer.

Most of the benefits of prostate-cancer screening occur after 10 years, the researchers said.

“This is to be expected from a disease with long lead-time and a long natural course,” the authors wrote. The men studied had a median age of 56 when they entered the research.

Men Over 70

“As the risk of over-diagnosis and over-treatment are still the major concerns in prostate-cancer screening, inviting men over age 70 for PSA screening seems questionable,” the researchers wrote.

The findings don’t imply that PSA screening programs should be introduced globally, wrote David Neal, a professor of surgical oncology at the University of Cambridge in England, in an commentary accompanying the study report.

Prostate-cancer screening has been controversial because the tests can detect cancers that don’t threaten the patients’ health, resulting in unnecessary treatment that can impair quality of life, Neal wrote.

“Current programs that raise awareness and provide balanced information about the pros and cons of screening seem to be the right way forward,” he wrote.

The test detects the presence of a protein made by the prostate gland called prostate-specific antigen, or PSA. Higher concentrations of PSA in the blood point to a greater risk of prostate cancer.

The Swedish Cancer Society, the Swedish Research Council and the U.S. National Cancer Institute funded the study.

To contact the reporter on this story: Kristen Hallam in London at khallam@bloomberg.net