PSA screening reduces prostate cancer mortality

Prostatic-specific antigen (PSA) testing appears to considerably reduce mortality from prostate cancer over an 11-year period, but has no significant impact on all-cause mortality, a European study published in NEJM (New England Journal of Medicine) reported today. Fritz H. Schröder, M.D., and team explain that PSA-screening has been the focus of several studies over the last few years, many with confusing and contradictory results. They set out to update information on prostate-cancer mortality. They report on data from the "European Randomised study of Screening for Prostate Cancer". This study included data on 182,160 adult males, aged between 50 and 74 years at entry. Men from eight countries in Europe were studied. They were randomly selected into two groups: PSA-screening group. The men were offered PSA-based screening. No screening group. The men were not offered PSA-based screening. They were specifically looking out for prostate cancer mortality. The authors found that the relative drop in risk of dying from prostate cancer was 21% in the PSA-screening group compared to the other group, and 29% after taking into account non-compliance (non-adherence). This was after an 11-year follow-up. They worked out that 1,055 PSA-screening invites are needed to prevent one death from prostate cancer (at 11 years). The researchers added that all-cause mortality between the two groups at 11-years was not significantly different between the two groups. In an Abstract in the same journal, the authors concluded: "Analyses after 2 additional years of follow-up consolidated our previous finding that PSA-based screening significantly reduced mortality from prostate cancer but did not affect all-cause mortality."