Screening for prostate cancer does not significantly reduce deaths – but may lead to unnecessary treatment, researchers said today.
The findings of a 20-year study are a set-back to hopes that screening might help protect men against this cancer.
Researchers say screening considerably increases risk of over-detection and over-treatment.
The conclusions, published on the British Medical Journal, are based on a trial that started in Sweden in 1987 involving 9,026 men aged 50-69 years.
Of those participants, 1,494 men were randomly selected for screening every third year from 1987 to 1996, while the remaining 7,532 were controls.
On the first two occasions, screening was done by physical examination only, but from 1993, this was combined with prostate specific antigen (PSA) testing.
In 1996, for the fourth examination, only men aged 69 or under at the time of the investigation were invited for screening.
All men with cancer diagnosed up to December 31, 1999 were included in the analysis and survival was followed until December 31, 2008.
The authors found that 85 men – 5.7 per cent – were diagnosed with prostate cancer in the screened group and 292 – 3.9 per cent – in the control group.
The tumours in the screening group were smaller and more often localised than in the control group.
Analysis did not show significantly longer survival or overall survival for men with prostate cancer in the screened group compared with the control group.
The authors say that although screening and treating men with detected tumours might reduce deaths specifically from prostate cancer by up to one-third, it would be at “considerable risk of worrying over-detection and unpleasant or harmful over-treatment”.
“After 20 years of follow-up, the rate of death from prostate cancer did not differ significantly between men in the screening group and those in the control group,” they conclude.
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