More Support for Prostate Cancer Screening? — Physician’s First Watch
More Support for Prostate Cancer Screening?
By Amy Orciari Herman
Edited by David G. Fairchild, MD, MPH
A reanalysis of U.S. and European data seems to offer more support for prostate-specific antigen (PSA)-based screening for prostate cancer. The findings appear in the Annals of Internal Medicine.
Researchers reexamined data from the European Randomized Study of Screening for Prostate Cancer, which originally showed a reduction in prostate cancer mortality with screening, and the U.S. Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which showed no reduction. In the new analysis, the researchers attempted to account for the high rate of PSA screening that contaminated the control group of the U.S. trial. Ultimately, they concluded that the results of both screening trials could be consistent with roughly a 25%–30% reduction in prostate cancer mortality over 11 years' follow-up.
Dr. Allan S. Brett, editor-in-chief of NEJM Journal Watch General Medicine, weighed in: "I'd like to see critical analysis of this report by other groups with sophisticated statistical expertise. But in the end, it doesn't really matter whether the U.S. data legitimately can be interpreted as supporting the European data. We already know (from the European trial) that screening likely confers a small absolute reduction in prostate cancer mortality, but that many men must be treated (or subjected to repeated testing and biopsy) to benefit one person. So this latest analysis doesn't change anything: We're still left with the same debate about benefit vs. harm in PSA screening."
Stay tuned for NEJM Journal Watch General Medicine's coverage of this new analysis in the coming days.