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Single PSA Screening Doesn’t Cut Prostate Cancer Mortality

But screening is associated with increased detection of low-risk prostate cancer

TUESDAY, March 6, 2018 (HealthDay News) — A single prostate-specific antigen (PSA) screening is not associated with a significant difference in prostate cancer mortality after follow-up of 10 years, but is associated with increased detection of low-risk prostate cancer, according to a study published in the March 6 issue of the Journal of the American Medical Association.

Richard M. Martin, Ph.D., from the University of Bristol in the United Kingdom, and colleagues invited 419,582 men aged 50 to 69 years at 573 primary care practices to attend a PSA testing clinic and receive a single PSA test versus standard practice (unscreened).

The analysis included 189,386 men in the intervention group and 219,439 in the control group. The researchers found that after a median follow-up of 10 years, the rate of death from prostate cancer was 0.30 and 0.31 per 1,000 person-years in the intervention and control groups, respectively (rate ratio, 0.96; 95 percent confidence interval, 0.85 to 1.08; P = 0.50). A higher number was diagnosed with prostate cancer in the intervention versus the control group (4.3 versus 3.6 percent; rate ratio, 1.19; 95 percent confidence interval, 1.14 to 1.25; P < 0.001). In the intervention group, more prostate cancers with Gleason grade of 6 or lower were identified (1.7 versus 1.1 percent; P < 0.001).

“Although longer-term follow-up is under way, the findings do not support single PSA testing for population-based screening,” the authors write.

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