Screening men for prostate cancer may not reduce their risk for dying, according to a new study in the January 9 issue of Archives of Internal Medicine.
More men will have been diagnosed with prostate cancer than any other cancer in 2005 and more than 30,000 men will have died from the disease, according to background information in the article. Men can be screened for prostate cancer by measuring prostate-specific antigen (PSA) levels in the blood and performing digital rectal examination. However, there is little evidence of these tests' effectiveness in reducing death, the authors report. In this context, medical groups differ on screening guidelines; for instance, the American Cancer Society states that doctors should offer the PSA blood test and digital rectal exam annually to men age 50 years or older, whereas the U.S. Preventive Services Task Force has found insufficient evidence to recommend screening and the American College of Physicians advises physicians to counsel men about its benefits and risks.
John Concato, M.D., M.P.H., from the Veterans Affairs (VA) Connecticut Healthcare System, West Haven, and Yale University, New Haven, and colleagues conducted a study to address the question of whether screening improves the chances of survival. From approximately 72,000 veterans receiving health care at any of 10 VA medical centers in New England, they identified 501 men age 50 years and older who were diagnosed with prostate cancer between 1991 and 1995 and had died by the end of 1999. A comparison group of 501 living men was also identified; each man in this control group was matched, for age and treatment at the same center, to a man with prostate cancer who had died. Medical records were reviewed to determine whether men in either group had been screened for prostate cancer.