Screening simplified

It’s hard to keep up with the controversy over wide scale PSA screening for prostate cancer, and whether it causes more harm than good.

My general impression is that there is pretty good evidence for the nay-sayers (see this brief report last year), yet you still get things opening like a new Prostate Screening clinic in Brisbane just a couple of months ago, so clearly some think promoting widespread screening is worthwhile (although perhaps mainly for the clinic’s pockets?)

Anyhow, this report from the Guardian indicates that maybe you get just as well by getting just one PSA test done at the right age:

Professor Philipp Dahm and colleagues at the University of Florida reviewed six previous screening trials involving 387,286 participants.

They found routine screening aided the diagnosis of prostate cancer at an earlier stage, but did not have a significant impact on death rates and raised the risk of over-treatment.

A second study headed by Professor Hans Lilja, showed a single "prostate-specific antigen" (PSA) level test at age 60 strongly predicted a man's risk of diagnosis and death from prostate cancer.

The team found 90% of prostate cancer deaths occurred in men with the highest PSA levels at age 60, while men with average or low PSA levels had negligible rates of prostate cancer or death by age 85.

The findings suggested at least half of men aged 60 and above might be exempted from further prostate cancer screening.

Sounds reasonable.