Organized screening for prostate cancer does more harm than good
Prostate cancer screening using the prostate-specific antigen (PSA) test is widely used in France despite a lack of evidence showing that it reduces cancer deaths. Now, researchers have shown that men experience more harm than good from routine PSA screening, according to research to be presented on Monday by Professor Mathieu Boniol, at the 2013 European Cancer Congress (ECC2013) .
Prof Boniol, Research Director at the International Prevention Research Institute (iPRI) and Professor at the Strathclyde Institute for Global Public Health at iPRI, Lyon, France, will tell the congress that the total harm men experience in terms of impotence and incontinence, and the side-effects from prostate cancer treatments, severely affects their quality of life, and should further discourage the use of PSA testing for prostate cancer screening.
Prof Boniol will say: "The test measures PSA protein levels, which are produced by the prostate gland, in a man's blood, and may help detect early cancer. However, we believe that PSA testing should be used as an additional aid in the diagnosis and management of prostate cancer rather than as the major entry point for prostate biopsy and further examinations. PSA testing should be reduced and more attention should be given to the harmful effects of screening related to the use of the test.
"We wanted to provide clinicians with a better idea of the consequences of organised PSA screening and we thought that providing numbers for the different side-effects following PSA testing would be easiest to interpret. Therefore, we estimated the total harm that men could endure if exposed to PSA testing by applying different side-effect estimates to a virtual population of 1,000 men aged 55
 European Journal of Cancer, Vol 49, issue 6 (April 2013), pages 1374-403."Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012." Available from: eco.iarc.fr. Accessed on 01 July 2013.
 Professor Sternberg is Chief of the Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy.
 The work was funded by the International Prevention Research Institute, Lyon, France.
Abstract nos: 1481, "Number needed to harm in prostate cancer screening with PSA", and 2857, "Mortality rate 60 days following radical prostatectomy in France". Epidemiology and Prevention – poster session, 9.30-12.00 hrs (CEST), Monday 30 September, Hall 4 and Genitourinary Malignancies – Prostate Cancer – poster session, 9.30-12.00 hrs (CEST), Monday 30 September, Hall 4 and poster discussion session, 11.30-12.30 hrs (CEST), Monday 30 September, Hall 7.2.