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Prostate screening doubts unresolved

Thurs March 19th, 2009

Screening men for cancer may save lives - but programmes may not be beneficial experts warned last night.

Two major studies on prostate cancer screening gave conflicting results. And experts said they still need to answer questions about over-treatment.

A European study involving more than 160,000 men in seven countries concluded that screening can reduce deaths by 20 per cent. Screening detects a substance called PSA.

The findings are being reported at the conference of the European Association of Urology in Stockholm, Sweden, and also on-line by the New England Journal of Medicine.

The Journal was also reporting a second, US, study showing now reduction in death rates.

Professor Fritz Schröder, who led the European study, said: This provides decision makers on screening policies with important new data on the effectiveness of PSA testing in preventing deaths.

"However, the European Randomised Study of Screening for Prostate Cancer is also near to completing additional studies on quality of life and cost-effectiveness and these must be assessed before making a decision about the appropriateness of a national prostate screening policy."

Cancer Research UK warned that screening could lead to unnecessary and unpleasant treatment for many men, leading to impotence and incontinence.

Chief clinician Professor Peter Johnson said: "It's very difficult to prove even in large trials like this that PSA screening has a direct impact on reducing cancer deaths, so we need to see what the results will be with longer follow up.

"For some men, detecting prostate cancer early through screening can be life saving while for others it will lead to unnecessary treatment and side effects like impotence and incontinence."

The European study has already established that about 30 per cent of cases detected by screening are slow growing and non-aggressive - or indolent - and may not need treatment.

Earlier this week the UK chief medical officer Professor Sir Liam Donaldson called for more research to distinguish dangerous prostate cancers from the slow-growing kind.

New England Journal of Medicine

Tags: Men’s Health | Cancer | UK News | North America | Europe

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