Prostate cancer screening can save lives but absolute benefit is small', study says

"Screening with the prostate-specific antigen (PSA) test reduced prostate cancer deaths by two for every 1,000 men screened, meaning 500 men must be screened to prevent one death from the disease. The benefit became apparent as patients were monitored for longer periods, in particular during the European randomized study of screening for prostate cancer (ERSPC), which followed men for 23 years after screening."

"Prostate cancer screening does reduce prostate cancer mortality, although the caveat is that it takes a very extended period of time to realise that benefit. The UK and many other countries have no formal prostate cancer screening programmes, largely because the PSA test is unreliable. As well as picking up life-threatening tumours, it detects a lot of benign cancers that may never cause problems."

"This can result in men having radiotherapy, surgery or hormone therapy, putting them at risk of complications such as incontinence and impotence. The studies in the review did not systematically assess the impact of screening on men's quality of life, but the ProtecT trial found that between 8% and 47% of men reported problems with urinary or sexual function after radiotherapy or surgery for prostate cancer."

"The results were not a blanket endorsement of universal screening and stressed the very real risks of overdiagnosis and unnecessary treatment. It's important to have, ultimately, discus"

Six trials involving nearly 800,000 men show that PSA-based screening reduces prostate cancer mortality by about two deaths per 1,000 men screened. Preventing one death requires screening roughly 500 men. The mortality benefit becomes clearer with longer monitoring, including follow-up extending to 23 years in the ERSPC study. PSA screening can detect life-threatening cancers, but it also identifies benign cancers that may never cause symptoms. This can lead to unnecessary radiotherapy, surgery, or hormone therapy, increasing risks such as incontinence and impotence. Quality-of-life effects were not systematically assessed across the trials, though the ProtecT trial reported urinary or sexual function problems in 8% to 47% of men after treatment.

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