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Testing for prostate cancer – more harm than good?

Recent research has suggested that regularly testing men for signs and symptoms of prostate cancer could cut deaths from the disease by more than 20 per cent, but some sources have suggested that such a huge number of tests could lead to some treatments being carried out needlessly.

Currently, prostate cancer testing involves a blood test which searches for prostate-specific antigen which signal the presence of prostate cancer within the patient. Although these antigens don’t always signal the presence of an aggressive prostate cancer which needs aggressive treatment, doctors often treat it as such, leaving male patients with impotence and incontinence side effects for cancers which could have benefitted from a less invasive or aggressive treatment programme.

The study, which was carried out over a period of twenty years, involved the participation of more than 162,000 men in eight varying European countries. Prostate-specific antigen (PSA) tests were carried out every four years on 50% of the participants, whereas the remaining 50% were sent to only contact doctors if symptoms of the disease presented themselves. After 13 years of the study, there were only 355 deaths in the group which was regularly screened in contrast to the 545 deaths in the group which were left to visit a doctor if symptoms were presented – a 21% decrease in deaths.

These statistics mean that 27 extra cases of prostate cancer need to be found in order to prevent one death, and in almost half of the cases men were given gruelling treatment which was linked to serious side-effects, said the famous medical journal, The Lancet.

Fritz Schroder, who helped lead the research team said, “PSA screening delivers a substantial reduction in prostate cancer deaths, similar or greater than that reported in screening for breast cancer. However, over-diagnosis occurs in roughly 40 per cent of cases detected by screening, resulting in a high risk of over-treatment and common side-effects such as incontinence and impotence. The time for population-based screening has not yet arrived.”

Iain Frame, director of research at Prostate Cancer UK said that the results of the study showed ‘the urgent need for a test which can distinguish between dangerous cancer and those which may never cause any harm’. “Without a reliable test, the introduction of a screening programme could mean an enormous rate of over-diagnosis and therefore over-treatment of potentially harmless cancers.” He added.

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