Routine prostate cancer screening 'not needed'

Researchers have today said there is not enough evidence to support routine prostate cancer screenings.

The use of population-wide screening using the prostate specific antigen (PSA) test, can lead to over-diagnosis and over-treatment of healthy men, according to the authors of new researchers

In two papers published on the British Medical Journal (BMJ) website today, researchers said the controversial use of the test often led to false positive results, and warned men should be fully aware of the risks and benefits of PSA before they undertake the test.

PSA is a protein produced in cells in the prostate gland, and is present in small quantities in the blood of healthy men. It is often elevated in men with prostate cancer and in men with benign prostatic enlargement.

Authors of the study, from Sweden, used PSA test results from 540 men diagnosed with prostate cancer and from 1,034 controls; they found the test did not achieve the 'likelihood ratios' required for a screening test.

The authors concluded: 'Additional biomarkers for early detection of prostate cancer are needed before population based screening for prostate cancer should be introduced.'

In the second report, researchers from the US concluded that data on the costs and benefits of PSA use remain insufficient to support population based screening. They added: 'The financial and psychological costs of false positive results, over-diagnosis and overtreatment of prostate cancer need to be measured more precisely.'

Supporting the research, an accompanying editorial from Dr Dragan Ilic and Professor Sally Green at Monash University in Australia said: 'Clinicians and patients are faced with many uncertainties when considering whether or not to undergo prostate screening.

'Further research is required to develop and evaluate a valid screening test for prostate cancer.

'Until such a test is available, a shared decision making approach to undertaking screening should be adopted.'