No Routine PSA Screens for UK Men

Posted on December 6th, 2010 in Uncategorized by Karl

The United Kingdom’s National Screening Committee has recommended against routine screening for prostate cancer risk with prostate specific antigen (PSA) testing.

The U.K. screening committee concluded that the PSA test’s potential harms — including worry and anxiety due to the reported high number of false positives — outweigh any potential benefits.

The panel noted that benign enlargement of the prostate or a urinary infection can also lead to elevated serum PSA levels.

Still, the committee recommended giving a PSA test to any patient who requests one.

“The ‘informed choice’ program should ensure men receive clear and balanced information about the advantages and disadvantages of the PSA test and treatment for prostate cancer,” the committee wrote in its review documents.

The screening committee’s findings were based on evidence from three clinical trials — the European Randomized Study on Screening for Prostate Cancer (ERSPC), the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO), and the Prostate Testing for Cancer and Treatment Trial (ProtecT).

The U.K. panel began its review in March 2009, after a new analysis from the ERSPC found a 20% mortality benefit from prostate cancer screening (albeit with a “great deal of ‘over diagnosis,’ ” the committee noted).

Subsequent models by the School of Health and Related Research in Sheffield, England, found that a single screen at age 50 has little effect on age-specific incidence of prostate cancer, and found little benefit for annual or biannual screens.

The committee’s main conclusions included the determination that PSA is “a poor test for prostate cancer and a more specific and sensitive test is needed,” and that the test is “unable to correctly identify those cancers which will progress and those which … may be safely watched.”

The panel also emphasized that data related to incidence, prevalence, and treatments are poor and “renders planning very difficult.”

The policy will be reviewed again in three years unless there is “significant new peer-reviewed evidence,” the committee added.

Source: MedPage Today 12/6/2010