Single PSA screening for prostate cancer does not improve survival rates

One-time prostate-specific antigen (PSA) cancer screenings in men does not improve mortality rates for the disease, according to a study published online March 6 in JAMA.

Opinions vary widely on the trade-off between mortality benefit and risk of overtreatment surrounding PSA testing. Researchers at the Universities of Bristol and Oxford in the United Kingdom determined testing men with PSA who show no sign of the disease detects cancers unlikely affect patients, but screening also misses aggressive and lethal prostate cancers.

Lead author Richard Martin, Cancer Research U.K. scientist at the University of Bristol, and colleagues conducted the Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP) over a 10-year period. More than 400,000 men ages 50 to 69 were included.

The trial compared 189,386 men who underwent a one-off PSA test with 219,439 men who did not receive a screening.

The trial, spanning nearly 600 general practitioner practices, is the largest to investigate prostate cancer screening, according to a release.

After an average of 10 years follow up, there were 8,054 (4.3 percent) prostate cancers in the screened group and 7,853 (3.6 percent) cases in the control group. Both groups had the same percentage of men dying from prostate cancer (0.29 percent).

“Our large study has shed light on a highly debated issue. We found that offering a single PSA test to men with no symptoms of prostate cancer does not save lives after an average follow-up of 10 years,” said Martin in the release.

In the U.K., more than 11,000 men die of prostate cancer each year and nearly 29,000 more die annually in the U.S.

"The results highlight the multitude of issues the PSA test raises—causing unnecessary anxiety and treatment by diagnosing prostate cancer in men who would never have been affected by it and failing to detect dangerous prostate cancers," said Martin in the press release. “Cancer Research U.K. is funding work that will allow us to follow the men for at least a further five years to see whether there is any longer-term benefit on reducing prostate cancer deaths.”