No Benefit Seen From Annual Prostate Tests
Reported August 29, 2007
WASHINTON — A large study from Europe suggests it doesn’t hurt to wait a few years between prostate cancer screenings, but the research won’t end debate over the value of PSA tests.
Millions of U.S. men have their blood tested every year for PSA, or prostate-specific antigen, although routine screenings are controversial.
High PSA levels can mean cancer or just an enlarged prostate; only a biopsy can tell. Moreover, prostate cancer usually is slow-growing and there’s little way to predict which early-stage tumors will threaten life. Since treatment can cause incontinence or impotence, PSA testing may do more harm than good for some men.
European men receive less frequent PSAs, so Dutch scientists decided to see if skipping a few years mattered. They tracked 4,200 Swedish men tested every two years, and 13,300 men tested every four years in the Netherlands.
More frequent testing spotted more tumors overall, but didn’t reduce diagnosis of aggressive tumors that formed between visits, researchers report Wednesday in the Journal of the National Cancer Institute.
Researchers have noted before that increased screening for any type of cancer will increase diagnosis, but it’s not always clear if that reduces deaths.
Over a decade, 13 percent of the men tested every two years were diagnosed with prostate cancer compared with 8 percent of men tested every four years.
But only a handful of those aggressive between-test cancers formed in each group, a statistical tie, concluded researchers at Erasmus Medical Centre in Rotterdam.
The study doesn’t prove that four years between PSAs is safe, Dr. E. David Crawford of the University of Colorado cautioned in an accompanying editorial. The Dutch men may have been healthier.
Specialists hope that results of a huge U.S. study of PSA screening, due in 2009, will settle the question of how much benefit it really provides.
More than 218,000 U.S. men are expected to be diagnosed with prostate cancer this year, and about 27,000 men will die of it.