PSA Screening Cuts Prostate Cancer Deaths in Healthy Men

However, prostate cancer death risks not reduced in men with significant comorbidities

THURSDAY, Nov. 4 (HealthDay News) -- Prostate-specific antigen (PSA) screening in men in good health appears to reduce the risk of prostate cancer-specific mortality (PCSM) with minimal overtreatment, according to a study published online Nov. 1 in the Journal of Clinical Oncology.

E. David Crawford, M.D., of the University of Colorado Health Sciences Center in Denver, and colleagues assembled data on PCSM for 73,378 men who, during 1993 to 2001, had been randomly assigned to either annual PSA screening or usual care and who had also completed a questionnaire that asked about the presence of comorbidities. The researchers analyzed these data to assess whether the PSA screening was associated with PCSM risk for men with a significant comorbidity compared to men with no or a minimal comorbidity.

In a 10-year follow-up, the researchers observed a significant decrease in the risk of PCSM in men with no or minimal comorbidity randomly assigned to annual PSA screening versus usual care, (adjusted hazard ratio, 0.56). The additional number needed to treat in order to prevent one death from prostate cancer by 10 years was five. However, for men with at least one significant comorbidity, those randomly assigned to annual PSA screening did not have a decreased PCSM risk.

"Specifically, intervention with annual PSA screening compared with usual care in men with no or minimal comorbidity was associated with the more frequent diagnosis of less advanced prostate cancer and a significant reduction in the risk of PCSM requiring the treatment of five additional men to eliminate one prostate cancer death at 10 years," the authors write.

Study authors disclosed financial ties to pharmaceutical and medical equipment companies.

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