New England Journal of Medicine Publishes Results of Two Prostate Screening Trials

Georgia Cancer Specialists Recommends Annual Prostate Cancer Screenings for Men Over 50

Two recent studies appearing in the New England Journal of Medicine challenge the effectiveness of routine prostate-specific antigen (PSA) screening for prostate cancer. Despite these findings, Georgia Cancer Specialists oncologists continue to recommend annual PSA screenings for men over the age of 50.

What the study says…

The New England Journal of Medicine recently published two back to back articles – one from a European group, and one from an American Group – of two clinical trials in which men were randomly assigned to receive PSA screening or not. The objective of the study was to assess the impact of PSA screening on death from prostate cancer. The interim data, at nine and sex-year follow ups respectively for the two trials, demonstrate the following:

• In the European study, more men were diagnosed with prostate cancer in the screening group, but more men died from prostate cancer in the no-screening (control) group. Regardless of which group these men were placed in, the absolute number of deaths was not very large, so many men diagnosed with prostate cancer may have needlessly undergone invasive treatment. 
• In the American study, which was designed slightly differently than the European trial, the overall death rate from prostate cancer was very low in both groups, and there was no benefit from PSA screening.

What this means for you… 

Overall, the initial results of these studies are eye opening; however, longer follow-up is required in order to show broad applicability for the general population. The studies also do not provide data regarding men who may be at higher risk – such as those with a family history of prostate cancer or African Americans, who develop earlier, more frequent, and more aggressive disease. 

These studies are ongoing and their presented findings are preliminary. Georgia Cancer Specialists oncologists recommend all men over the age of 50 receive annual PSA blood tests and a physical exam of the prostate by a physician. African American men should start testing at age 45.  The potential risks and benefits of PSA testing vary according to patient’s age, ethnicity, and family history.  Patients should discuss their individual situation with the physician performing the screening.