A targeted screening programme for prostate cancer would have significant benefits, a European conference has heard.
Analysis presented at the European Association of Urology annual congress (EAU22) showed men who underwent screening spent longer in the earlier stage of the disease without signs of progression.
Researchers from the Erasmus MC Cancer Institute at University Medical Centre Rotterdam, The Netherlands, analysed data from more than 43,000 men in the Dutch cohort of the European Randomised Study of Screening for Prostate Cancer (ERSPC), which recruited more than 180,000 men across eight countries in the 1990s. Half of these were randomised to enter a prostate cancer screening programme of regular PSA tests.
In this new study, the team examined how long it took before the men’s prostate cancer progressed to different stages of the disease following diagnosis and found that men in whom the disease was detected through a screening programme remained on average a year longer without progression.
Of the men whose disease had progressed, if it became metastatic it was on average two and a half years later compared to those whose cancer was detected outside the screening programme.
Sebastiaan Remmers, of the Erasmus MC Cancer Institute, said: “No-one wants to be confronted with a cancer diagnosis, and screening means more men know they have prostate cancer and live longer with that knowledge.
“While screening can lead to overdiagnosis, our research shows it can also postpone – or even avoid – the harm that prostate cancer can bring. That tips the balance in favour of further developing organised individualised screening programmes.”
Professor Monique Roobol, also of the Erasmus MC Cancer Institute, added: “Advances in how prostate cancer is diagnosed and treated have changed the balance of risks and benefits associated with screening for the disease.
“We can reduce the detection of low-risk cancers considerably by adequate risk stratification. In addition, in the past, diagnosis automatically meant radical treatment, such as surgery or radiation, which all have side effects.
“Now we have other options for low-risk cancers, such as active surveillance including MRI scans, which have a more limited impact on men’s quality of life. Given that screening reduces mortality and metastatic disease, and – as our research shows – gives men more years in those stages of the disease that have less impact, then the arguments against screening are becoming outdated.”
The European Association of Urology is calling for prostate cancer screening to form part of the European Union’s new ‘Beating Cancer’ plan.
How long do men stay in intermediate stages between randomization and death: Results of ERSPC Rotterdam presented to the European Association of Urology annual congress (EAU22) in Amsterdam on Saturday 2 July 2022.
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