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PSA test for prostate cancer doing more harm than good

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The standard prostate cancer screening test is doing more harm than good, a new study has found.

The PSA (prostate-specific antigen) test is producing false-positives—‘seeing’ a cancer that’s not there—in one in six screenings, or around 17 percent of the time.

Not only is the test producing high numbers of false-positives, but it’s also missing aggressive cancers that are there, say researchers from the universities of Bristol, Oxford and Cambridge.

They monitored around 400,000 men aged between 50 and 69 who had been invited for a prostate test, and around half had the PSA.  In the 15 years the men were tracked, around seven out of 1,000 in the screened group had died from prostate cancer compared to eight in the group that hadn’t been tested.

Not only was the mortality rate similar in both groups, one in six cancers ‘seen’ by the PSA test were benign or slow-growing, and yet were treated with standard cancer therapy that can be life-debilitating, resulting in incontinence and erectile dysfunction.

Lead researcher Prof Richard Martin at the University of Bristol commented: “The key takeaway is that the small reduction in prostate cancer deaths by using the test to screen healthy men does not outweigh the potential harms.

“This results in some men going on to have invasive treatment that they don’t need, many years earlier than without screening, and the test is also failing to spot some cancers that do need to be treated.”

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JAMA, 2024; doi: 10.1001/jama.2024.4011
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