Early prostate cancer screening may reduce mortality rate

July 08, 2005

Early screening of prostate cancer in asymptomatic men may reduce their risk of death from metastatic prostate cancer by as much as 35 per cent, researchers from the University of Toronto have found.

"Early screening with the prostate specific antigen (PSA) is quite controversial. There are many arguments both for and against the efficacy of this form of early screening," says Vivek Goel, professor of public health sciences and health policy management and evaluation at U of T and one of the senior authors of the study. "Our study shows a fairly significant benefit, and this benefit is demonstrated even among men who were not screened regularly as part of a screening program. There may be greater benefit from an organized screening program."

Published in the August issue of the Journal of Urology, Goel and Jacek Kopec, a professor at the University of British Columbia, did much of this work while both were part of U of T's public health sciences department. The researchers conducted a population-based case control study in the Greater Toronto Area of 236 men with advanced metastatic prostate cancer and a control group of 462 men who did not have metastatic prostate cancer. From 1999 to 2002, they matched subjects on age and area of residence and obtained self-reported information about their lifestyles, health history and utilization of health services. The researchers also received permission to review medical records and history of screening.

They found that PSA screening of asymptomatic men reduced their risk of metastatic prostate cancer by 35 per cent.

In North America, prostate cancer is the most frequently diagnosed cancer in men and the second leading cause of death by cancer in men, often as a result of the cancer spreading or metastasizing to other parts of the body. PSA tests are simple blood tests that detect an antigen in blood. While small amounts of this antigen are normal, higher levels could indicate problems like prostate cancer.

The controversy surrounding early PSA screening deals with false positives generated by high PSA scores. Hidden or localized prostate cancer does not always metastasize and people with this localized cancer may go on to live normal lives for years without incident.

"Just by chance alone you're going to be picking up some of those prostate cancers, and those people wind up getting labeled as prostate cancer patients," states Goel. "They get treatments for it, surgery, radiation, chemotherapy, hormonal therapy - all of which have side effects - not to mention the anxiety and angst associated with having prostate cancer as a label. But the reality also is that they may never have actually died of the prostate cancer because it was so localized."

When they compiled data results, Kopec and Goel, both of whom are public health epidemiologists, say they were surprised by the size of the protective effect. "What usually happens with tests like these is that clinicians tend to be very supportive while public health people tend to be more cautious," says Kopec. "The clinical members of our study team feel that these findings are confirming what they had believed all along; we were a bit more surprised. A 35 per cent difference is quite a large amount so from our perspective it is quite a significant link in the chain supporting that early prostate screening has a positive impact."

Ontario is among the half of Canadian provinces that does not cover the costs of PSA screening tests. Guidelines for physicians in Ontario recommend that men over 50 should be informed of the health risks and benefits of early screening by their family physician.
-end-
This research was supported by a grant from the Canadian Cancer Society and a National Health Scholar Award from Health Canada.

University of Toronto

Related Prostate Cancer Articles from Brightsurf:

Low risk of cancer spread on active surveillance for early prostate cancer
Men undergoing active surveillance for prostate cancer have very low rates - one percent or less - of cancer spread (metastases) or death from prostate cancer, according to a recent study published in the Journal of Urology®, an Official Journal of the American Urological Association (AUA).

ESMO 2020: Breast cancer drug set to transform prostate cancer treatment
A drug used to treat breast and ovarian cancer can extend the lives of some men with prostate cancer and should become a new standard treatment for the disease, concludes a major trial which is set to change clinical practice.

Major trial shows breast cancer drug can hit prostate cancer Achilles heel
A drug already licensed for the treatment of breast and ovarian cancers is more effective than targeted hormone therapy at keeping cancer in check in some men with advanced prostate cancer, a major clinical trial reports.

The Lancet: Prostate cancer study finds molecular imaging could transform management of patients with aggressive cancer
Results from a randomised controlled trial involving 300 prostate cancer patients find that a molecular imaging technique is more accurate than conventional medical imaging and recommends the scans be introduced into routine clinical practice.

Common genetic defect in prostate cancer inspires path to new anti-cancer drugs
Researchers found that, in prostate cancer, a mutation leading to the loss of one allele of a tumor suppressor gene known as PPP2R2A is enough to worsen a tumor caused by other mutations.

First prostate cancer therapy to target genes delays cancer progression
For the first time, prostate cancer has been treated based on the genetic makeup of the cancer, resulting in delayed disease progression, delayed time to pain progression, and potentially extending lives in patients with advanced, metastatic prostate cancer, reports a large phase 3 trial.

Men taking medications for enlarged prostate face delays in prostate cancer diagnosis
University of California San Diego School of Medicine researchers report that men treated with medications for benign prostatic hyperplasia (enlarged prostate) experienced a two-year delay in diagnosis of their prostate cancer and were twice as likely to have advanced disease upon diagnosis.

CNIO researchers confirm links between aggressive prostate cancer and hereditary breast cancer
The study has potential implications for families with members suffering from these types of tumours who are at an increased risk of developing cancer.

Distinguishing fatal prostate cancer from 'manageable' cancer now possible
Scientists at the University of York have found a way of distinguishing between fatal prostate cancer and manageable cancer, which could reduce unnecessary surgeries and radiotherapy.

Researchers find prostate cancer drug byproduct can fuel cancer cells
A genetic anomaly in certain men with prostate cancer may impact their response to common drugs used to treat the disease, according to new research at Cleveland Clinic.

Read More: Prostate Cancer News and Prostate Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.