New report advises against prostate cancer screening
Prostate cancer will kill around 4,000 Canadian men this year, but routine PSA screening isn’t helping to reduce this number, say experts.
The U.S Preventative Services Task Force released their updated recommendation that men should not be routinely screened for prostate cancer with PSA testing, which they say does more harm than good.
The findings suggest that widespread prostate cancer testing saves few lives and creates significant side effects and much unnecessary treatment, regardless of one’s age.
Current practice in many Canadian provinces are already in line with this recommendation.
It is likely, however, that this recommendation will go largely ignored and declared harmful, as similar breast cancer recommendation screenings were.
Based on their own experience, many survivors of cancer remain convinced that screening saves lives. This latest recommendation will likely inspire many men whose lives were saved tell their story of how the screening led to them avoiding death.
The recommendation that men not routinely undergo blood tests to measure a prostate specific antigen protein comes from two recent large studies and a thorough review of evidence.
The first study followed 75,000 men for ten years. Half of the participants were not screened, while the others were screened annually. The result? The number of deaths from prostate cancer was virtually identical for both groups.
The second study looked at 250,000 European men and found that in order to prevent just one death from prostate cancer, 1,055 men would need to be screened for a decade and 37 diagnoses of cancer made. The overall death rate for those offered screening and those who were not, did not vary.
The majority of patient groups in Canada and the United States endorse routine PSA screenings for men aged 40 to 69, but the Canadian Cancer Society falls in line with the Preventative Services recommendation, advising instead for men to talk to their doctor about their risk and the benefits and harms of early detection.
Screening for PSA itself doesn’t predict very well if a man has prostate cancer, as two thirds of men with higher PSA levels are found to not have the disease. In fact, one third of men with safer low levels of PSA do have it, which makes the screening itself unreliable.
Prostate cancer is slow growing and most men die with, not of, this type of cancer. Only a small percentage of these cancer cases are deadly — but as it stands there is no test available to distinguish the aggressive cases from the slow ones, meaning many men endure unnecessarily harmful treatment that can cause lifelong impotence and urinary incontinence.
Sources:U.S Preventative Services Task Force, Globe and Mail, Toronto Star