Screening for prostate cancer or not? This stays a vital query. Screening relies on a highly imperfect measurement, the prostate-specific antigen (PSA) blood test, which is susceptible to false positives. And with increasing evidence that screening for overtreated harms—particularly incontinence and impotence—advantages survival—the pendulum has steadily swung back. Still, screening research continues, with the hope that some life-saving advantages could also be found.
now Latest study Again casts doubt on PSA screening as an efficient public health tool.
British scientists divided greater than 400,000 men aged 50 to 69 into two groups: one screened for prostate cancer with a single PSA test, and the opposite not tested for the disease in any respect. . After a median follow-up of 10 years, the prostate cancer mortality rates were nearly an identical within the two groups. Cancers were detected more continuously within the screened group, but most were low-grade, requiring questionable treatment.
Called the Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP), the study's approach of giving men a single PSA test differs from the normal strategy of testing men repeatedly every few years. However, previous studies investigating repeated PSA tests have reached similar conclusions. one European Studies For example, with 162,000 men, it concluded that for each life saved by screening, 27 men can be diagnosed and treated for prostate cancer that will have been life-threatening if undetected. It wouldn't have happened.
During the CAP study, 189,386 men were assigned to screening and 219,439 men were assigned to a no-screening control group. After a median of 10 years, 549 of the screened men had died of prostate cancer, compared with 647 men within the control group who didn't get a PSA test. The variety of deaths from prostate cancer was higher among the many controls, however the variety of men on this group was similar. So the researchers adjusted for various sample sizes with statistical adjustments: They compared death rates by man-years, or the overall variety of years that men in each groups participated within the study. Analyzed as such, the study revealed 0.30 prostate cancer deaths per 1,000 person-years within the screened group, and 0.31 prostate cancer deaths per 1,000 person-years within the controls, which is negligible. There is a difference.
Dr. Barry, who was recently a member of the US Preventive Services Task Force, an influential group of independent experts that publicly discourages PSA screening, emphasized that the majority men who get the test They decide to take the test greater than once. And with each additional PSA test, he said, the chances of diagnosing prostate cancer increase. “But is re-screening worth the risk of a low-grade cancer diagnosis and all the treatment complications that come with it?” he asked. “It's hard for us as physicians to make these decisions for our patients. We need to make them. with to determine if they feel these risks are worth taking.”
Fortunately, Garnick added, men diagnosed with prostate cancer after a PSA test don't need treatment within the short or long run. Depending on the characteristics of the tumor, some people may select to observe their cancer with lively surveillance, which relies on periodic prostate biopsies or MRIs to look for brand spanking new signs that will require treatment. “Hopefully, current research that uses advanced genetic testing or prostate cancer biomarkers can help provide more accurate information about those who may benefit most from screening and treatment,” Garnick said. said “But we're not there yet.”
— Charlie Schmidt