Prostate cancer screening can reduce deaths by 13%, a study suggests.
Cancer screening experts are assessing whether the UK should introduce a screening programme for prostate cancer, with a decision expected before the end of the year.
The new study, published in the New England Journal of Medicine, suggests that a “targeted” approach to screening could be adopted to reduce deaths from the disease and also prevent problems arising from “overdiagnosis”.
Researchers examined the risks and benefits of screening across eight European countries over a 23-year period, including data on 162,000 men – with 72,000 of these invited for screening. They found that one death from prostate cancer was prevented for every 456 men who were invited for screening. And one death from prostate cancer was averted for every 12 men in whom prostate cancer was diagnosed.
Commentators said the findings are “comparable to that seen with breast or bowel cancer screening”.
As well as a reduction in deaths from prostate cancer, the authors of the study said screening has a “more favourable harm-to-benefit profile than previously estimated”. They also said harms linked to screening “remain a critical concern”. These include unnecessary testing, biopsies, overdiagnosis and subsequent overtreatment.
“These findings highlight the need for a more targeted strategy for prostate cancer screening that focuses on identifying population subgroups that are most likely to benefit from early detection while reducing unnecessary interventions for those with the highest risk of overdiagnosis,” they wrote.
The prostate-specific antigen (PSA) test is a blood test which is used to check for prostate conditions including prostate cancer or an enlarged prostate. Routine PSA testing is not offered on the NHS but men may be offered a PSA test if a GP suspects they have prostate cancer. Men over the age of 50 can ask their GP for a PSA test, even if they do not have symptoms.
Officials have faced increased calls for a screening programme to be introduced and will be weighing up the concerns outlined in the review.
Last week the National Institute for Health and Care Excellence (Nice) approved a new treatment option for men with prostate cancer which has spread to other parts of the body.
Nice initially rejected abiraterone, saying that it did not represent value for money for the NHS. But now it has said abiraterone and its generic variants can be used in combination with other treatments for newly diagnosed men with “high-risk hormone-sensitive” metastatic prostate cancer.
Nice said it was able to reverse its 2021 decision because of lower-cost generic versions of the drug. It said that about 4,000 men will now be able to benefit from the additional treatment option.
