Single prostate test proposal

Wednesday September 15th, 2010

There is no need for routine, general screening for prostate cancer, although a single test at 60 may be beneficial, two studies have concluded.

Doctors writing in British Medical Journal on-line have published a review of six randomised trials and concluded that there is insufficient evidence to support actively inviting all men in certain age groups to attend screening for prostate cancer.

A second report, also published on the site today, does recommend that a test at 60 could identify men who are most likely to develop and die from prostate cancer. They could then be monitored more closely, while others could be exempt from further screening.

Professor Philipp Dahm and colleagues at the University of Florida reviewed six trials, involving 387,286 participants, and found that although screening aids the diagnosis of prostate cancer at an earlier stage, it does not have a significant impact on mortality and comes at the risk of over-treatment.

Instead of routine screening, they suggest men should be better informed about the uncertainties associated with screening.

The second study by Professor Hans Lilja and colleagues reveals that a single prostate-specific antigen (PSA) level test at age 60 can strongly predict a man’s lifetime risk of diagnosis and death from prostate cancer.

They found that 90 per cent of prostate cancer deaths occurred in men with the highest PSA levels at age 60, whereas men with average or low PSA levels had negligible rates of prostate cancer or death by age 85.

• A study published in CANCER, a peer-reviewed journal of the American Cancer Society, has found that men aged between 55 and74 who have low baseline blood levels of PSA are unlikely to benefit from further screening and treatment.

• Cancer Research UK has identified a molecule in cells that could predict the success of radiotherapy to treat individual bladder cancer patients. Research published in Cancer Research today (Wednesday) looked at the quantity of a DNA repair protein called MRE11 in the bladder tumour tissue of 86 patients before radiotherapy.

British Medical Journal on-line September 15 2010

“Balancing the harms and benefits of early detection of prostate cancer.” Pim J. van Leeuwen, David Connolly, Teuvo L.J. Tammela, Anssi Auvinen, Ries Kranse, Monique J. Roobol, Fritz H. Schröder, and Anna Gavin. Cancer; Published Online: September 13, 2010 (DOI: 10.1002/cncr.25474).

Tags: Cancer | Internal Medicine | Men’s Health | UK News

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