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New prostate CA screening study: “the risk for overdetection and overtreatment is considerable”

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Here’s the study in the BMJ and an AP story on it.

Summary in a BMJ news release:

“Analysis did not show significantly longer survival or overall survival for men with prostate cancer in the screened group compared with the control group.

And while screening and treating men with detected tumours might reduce deaths specifically from prostate cancer by up to a third (at best), this would be at considerable risk of worrying overdetection and unpleasant or harmful overtreatment. Indeed, a previous trial found that to prevent one death from prostate cancer, 1,410 men would need to be screened and 48 treated.

The authors believe that men should be fully informed about the potential hazards of treatment, and the psychological effects of false-positive test results, before they are screened.

They also argue that the next goal for prostate screening should be to find ways of discriminating slow-growing (indolent) tumours from high risk tumours and to develop less aggressive treatment for indolent tumours, rather than to optimise sensitivity of the diagnostic tests.

“After 20 years of follow-up, the rate of death from prostate cancer did not differ significantly between men in the screening group and those in the control group,” they conclude. Results from randomised controlled trials of prostate cancer screening have been published in recent years, but none with 20 years of follow-up, they add. Long follow-up is necessary to draw definite conclusions about the benefits of screening.”

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Michael Kirsch, M.D.

April 1, 2011 at 11:00 am

The study may be new, but the findings and conclusions are old news.