(Ivanhoe Newswire) -- Prostate cancer screening in younger men and men at risk for the disease can be beneficial in reducing metastatic cancer and death.
Recent research from a large, randomized trial of 162,243 men in Europe aged 55 to 69 years shows screening reduces deaths caused by prostate cancer. Other trials, such as the US Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, showed no benefit in screening.
"Cancer-specific mortality, not overall mortality, is the primary outcome in screening trials," Dr. Monique Roobol, Department of Urology, Erasmus University Medical Centre, Rotterdam, the Netherlands, was quoted as saying.
"Because deaths from prostate cancer are a small proportion of all deaths, comparisons of overall mortality are underpowered. Thus, a screening program that reduces cancer-specific mortality should not be stopped because of a lack of reduction in overall mortality," Roobol said.
The European Randomized Study of Screening for Prostate Cancer found screening can also reduce the incidence of metastatic cancer. The study found a 41% reduction in metastatic disease at diagnosis of the cancer with screening.
For elderly men with several medical issues, screening may be more harmful than beneficial, but for younger, healthy men, screening can reduce death from prostate cancer. Healthy younger men also are at lower risk of complications from biopsies and treatments compared with older men.
"Rather than abandoning a screening test that reduces death and suffering, efforts should be focused on selecting patients more carefully," Roobol said.
"Screening should be encouraged for healthy younger men and men with risk factors (e.g., black ancestry, positive family history) and discontinued for elderly men with multiple comorbidities and limited life expectancy."
The Canadian Task Force on Preventive Health Care, which recommended against PSA screening in its last guidelines in 1994, is expected to issue updated recommendations in 2013.
SOURCE: Canadian Medical Association Journal, May 2012
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