Prostate cancer screening no benefits for men with low PSA value

A new study published in Cancer suggests that prostate specific antigen (PSA) testing may not benefit men aged 55 to 74 who have low PSA value.

The study found for men with PSA levels between zero and 1.9 ng/mL, 24,642 men would need to be screened and 724 cases of prostate cancer would need to be treated in order to prevent just one death from prostate cancer.

For the study, Pim van Leeuwen, MD, of the Erasmus University Medical Centre in Rotterdam, the Netherlands analysed data from 43,987 men aged 55 to 74 years who participated between 1993 and 1999  in the European Randomized Study of Screening for Prostate Cancer (ERSPC) study in the Netherlands, Sweden, and Finland.

The analysis also included data from an additional 42,503 men in the same age range from Northern Ireland who had their PSA levels measured between 1994 and 1999.

The researchers found the PSA blood test seemed to be more reasonable for men with their baseline PSA levels between 10 and 19.9 ng/ml, to be exact, 133 men would need to be screened to prevent one death from prostate cancer. 

PSA testing is not a reliable test for prostate cancer, according to Dr. Richard Ablin of the University of Arizona, the discoverer of this screening method.  

He was cited as saying in a commentary on the New York Times that his method should not be used to screen prostate cancer for healthy men who have no family history of this malignancy for two reasons, first, it can't detect prostate cancer and second, it can't reveal whether a prostate cancer is lethal or benign.

The problem with this PSA testing is that high levels of PSA value do not always suggest a man is suffering prostate cancer and even if he is, the test can in no way tell whether the disease needs to be treated.

There are basically two types of prostate cancer, one type is aggressive, which can post life-threatening risk and the other is simply benign and would not pose any life threatening risk.

In any case, men aged 70 or older should not go get the screening because they are more likely to die from other causes, early stduies suggest. When they get the screening, subsequent diagnosis and treatment may likely do more harm than good.

Prostate cancer, which is a Western disease, is diagnosed in about 218,000 men and kills 32,000  in the United States each year, according to the National Cancer Institute.

Jimmy Downs