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A major trial has found that prostate cancer All men above 50 years of age will be screened save thousands of lives In Britain.
The study included data from 162,000 men aged 55 to 69 in eight European countries over a 23-year period.
Data suggest that a “targeted” approach to screening can be adopted reduce deaths from disease And also prevents problems arising from “over-diagnosis”.
After examining 72,000 men, researchers found that one death from prostate cancer was prevented for every 456 men screened.
The study, published in the New England Journal of Medicine, also found that one prostate cancer death was averted for every 12 men who were diagnosed with prostate cancer.
Commentators said the findings were “comparable with breast or bowel cancer screening”.
As well as reducing prostate cancer deaths, the study authors said screening “has a more favorable harm-to-benefit profile than previously estimated”.
They wrote, “These findings highlight the need for a more targeted strategy for prostate cancer screening that focuses on identifying those subgroups of the population most likely to benefit from early detection while minimizing unnecessary interventions for those at highest risk of overdiagnosis.”
Cancer screening experts are currently assessing whether the UK should launch a screening program for prostate cancer and are expected to make a decision before the end of this year.
Currently, the prostate-specific antigen (PSA) test is a blood test used to screen for prostate conditions, including prostate cancer or an enlarged prostate.
Routine PSA testing is not currently offered on the NHS, but men may be offered a PSA test if a GP suspects they have prostate cancer.
Men over the age of 50 can ask their GP for a PSA test even if they don’t have symptoms, but officials have faced growing calls to launch a screening programme, and the concerns outlined will be considered in the review.
A recent study published in the BMJ also found that prostate cancer blood tests may lead to men being over-tested, while those who need help may be missed.
Commenting on the new study, Nick James, Professor of Prostate and Bladder Cancer Research at The Institute of Cancer Research, London, said: “The latest analysis from ERSPC (European Randomized Study of Screening for Prostate Cancer) further strengthens the evidence base in favor of PSA-based prostate cancer screening.
“With long-term follow-up, the overall reduction in risk of death is comparable to the reduction seen with breast or bowel cancer screening.”
He added: “The well-known harms of screening, overdiagnosis and overtreatment can be substantially reduced by technologies such as MRI pre-biopsy and surveillance.
“Treatment side effects, such as incontinence, are at significantly lower rates than those recorded in trials with modern surgery and radiotherapy, making the case for screening even stronger.”
Commentators stated that the harms associated with screening “remain a serious concern”, including unnecessary testing, biopsies, overdiagnosis, and subsequent overtreatment.
Dr Matthew Hobbs, director of research at Prostate Cancer UK, said the trial showed that “the balance between the benefits and harms of screening with the PSA test is better than previously thought”.
“Although a large number of men were treated excessively – a large reason is that we currently do not have screening – this number has also reduced in this latest analysis,” he said.
“This is absolutely the high-quality evidence that the national screening committee needs to consider when making decisions about whether to screen men later this year, especially for high-risk men such as black men and men with a family history.”
Dr Ian Walker, executive director of policy at Cancer Research UK, said that while the long-running study shows that screening using the PSA test can help reduce prostate cancer deaths, “it also concludes that screening still causes harm”.
“Men included in the screening group were twice as likely to be diagnosed with low-risk disease than those who were not screened, often leading to unnecessary and sometimes aggressive treatment,” they said.
“The authors highlight that screening all men carries a significant risk of unnecessary testing, overdiagnosis, and overtreatment due to PSA testing issues.”