by Prostate cancer screening is likely to do more harm than good, experts have warned, after a 15-year trial showed one in six cases was a false flag.
The largest study to date investigating the PSA (prostate-specific antigen) blood test, used as a screening tool in some European countries, found that it had a small effect on reducing deaths, but there was a worrying level it also leads to overdiagnosis.
In some cases, some aggressive cancers were not detected early.
Researchers from the universities of Bristol, Oxford and Cambridge, invited more than 400,000 men aged 50-69 for screening, and just over half received a PSA test.
After 15 years of follow-up, almost seven men in 1,000 in the group invited for screening died of prostate cancer, compared with almost eight men in 1,000 who were not tested.
The results of the trial show that one in six cancers detected by the single PSA screening were overdiagnosed, leading to unnecessary treatment of tumors that would have caused no harm in a person’s lifetime.
Prostate cancer treatment can cause physical side effects, including the possibility of infection after a biopsy, erectile dysfunction, and bladder and bowel problems.
Professor Richard Martin, lead author and Cancer Research UK scientist at the University of Bristol, said: “The important thing is that the small reduction in prostate cancer deaths by using the test to screen healthy men does not outweigh the potential harms.
‘Some men get treatment they don’t need’
“This results in some men receiving invasive treatment that they do not need, many years earlier than without screening, and the test misses some cancers that need to be treated.
“We need to find better ways to detect aggressive prostate cancer, so we can treat them early.”
Prostate cancer is the second biggest cancer killer for men in the UK, killing 12,000 a year.
It is the most common cancer in the UK without a screening programme, despite the fact that it usually has no symptoms until it has spread and is incurable.
The UK’s National Screening Committee (NSC), which reviews the evidence for screening programmes, does not currently recommend screening for prostate cancer because it is not clear that the benefits outweigh the harms.
Dr Neil Smith, GP for Cancer Research UK and GP for Lancashire and South Cumbria Cancer Alliance, said: “With prostate cancer causing 12,000 deaths in the UK every year, we completely understand why men want to know do they even have the disease. when they do not have symptoms.
“However, this research shows that PSA testing for early detection can do more harm than good – it’s not accurate enough and some men may get tests and treatment they don’t want.
“You know your body best – so if you notice any unusual changes, contact your GP. It probably won’t be cancer, but if it is, treatment is more likely to be successful if it’s found earlier.”
Early prostate cancer usually has no symptoms so early detection is challenging.
Last year Prostate Cancer UK launched the £42m Transform trial, which will study hundreds of thousands of men, to see if MRI scans can do a better job of picking up disease early.
Other research, such as the Stampede trial, aims to find the best treatment for men with advanced prostate cancer to further improve survival and quality of life.
Dr Matthew Hobbs, Director of Research at Prostate Cancer UK, said: “A previous trial showed that screening with PSA blood tests reduces prostate cancer deaths but also misses important cancers and harms men who are given treatments or biopsies ‘. t need
“The results from the UK CaP trial are particularly significant, as they support these findings.
“The number of men screened and who died of prostate cancer in both trials makes it clear that it is now imperative to develop, test and prove new ways of diagnosing prostate cancer that find those aggressive cancers missed by PSA tests and which will even reduce the potential harm. More.”
In a separate study, researchers found that cutting the length of MRI scans for prostate cancer by a third would make them cheaper and more accessible without compromising accuracy.
Clinicians offer patients with suspected prostate cancer an MRI scan, which is done in three stages.
The final step involves injecting the patient with a contrast dye, which helps to enhance the images from the scan.
Removing this step would reduce costs and ensure MRIs were available to more men, said researchers from University College London (UCL) and University College London Hospitals NHS Foundation Trust.
But they warned that it is “vital” that the scans are of “optimal diagnostic quality” if this approach is to be adopted.
