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What Doctors Don't Tell You

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August 2019 (Vol. 4 Issue 6)

PSA prostate cancer test not fit for purpose
About the author: 
Bryan Hubbard

PSA prostate cancer test not fit for purpose image

The PSA screening test for prostate cancer isn't fit for purpose. It isn't saving lives, and it's even missing cancers that are potentially lethal, a major new study has concluded.

The PSA (prostate-specific antigen) is a simple blood test that men over the age of 50 are invited to have—but plans to make it a routine test for all over-50s will probably be shelved following the damning review from the University of Bristol, funded by Cancer Research.

Of the men who developed prostate cancer during the study, those whose cancer was detected by PSA were no more likely to be alive 10 years later than those who didn't have the test, the researchers discovered. The number of men diagnosed in either group was roughly the same, as was the 10-year survival rate.

The researchers tracked 189,386 men who had one PSA screening and compared their progress with 219,439 men who hadn't been screened but had a simple medical examination.

But it wasn't always picking up aggressive cancers that might be lethal, and sometimes it was 'seeing' cancers that weren't there—known as false-positives—or being unable to distinguish between aggressive cancers and those that were low risk and would not threaten the person's life. Nonetheless, the results still caused anxiety and even unnecessary treatment.

Lead researcher Prof Richard Martin said: "The results highlight the multitude of issues the PSA test raises, causing unnecessary anxiety and treatment by diagnosing prostate cancer in men who would never have been affected by it and failing to detect dangerous prostate cancers."


(Source: JAMA, 2018; 319: 883-95)

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