The PSA test, which measures levels of Prostate-Specific Antigens, is an invaluable exploratory method to determine a person’s likelihood of developing prostate cancer. With recent disagreements regarding its efficiency, investigators from the University of Gothenburg presented some relevant data on the matter.
“This research is important because it shows the long-term effects of an organized screening program in Sweden”, explained Maria Frånlund, MD, Ph.D
In 2018, the Swedish National Board of Health and Welfare recommended that “health services should not offer screening with PSA testing alone. The reason is that the Board regards the drawbacks of PSA screening — overdiagnosis and overtreatment — as outweighing its benefits”.
Frånlund’s work is based on a large, population-based study that began in Gothenburg in 1995. The program is unique and currently has the longest follow-up period of all screening studies on prostate cancer worldwide.
The Randomized Population-Based Prostate Cancer Screening Trial enrolled a total of 20,000 men with ages between 50 and 64. Ten thousand were randomly selected for a screening group and offered PSA testing (screening) every two years and cell sampling if elevated PSA levels were found. The other 10,000 were assigned to the control group and not offered PSA sampling in the study.
22 years later, approximately 300 fatalities were recorded as a result of prostate cancer. Overall, the group of men who had undergone screening in the program had a lower risk of death from the disease by 30%.
PSA levels on the first screening occasion proved to have a major bearing on future cancer outcomes. This could become an important element in risk estimation.
Frånlund considers that men should be offered continual checkups after a certain age and have access to optimized screening programs.
The American Cancer Society reports approximately 175,000 new cases each year. About 1 in 9 men will be diagnosed with prostate cancer during his lifetime. Early detection can significantly influence the outcome, which is why men are often encouraged to talk to their doctor and seek screening.
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