This week a large European consortium updated the data on a huge study on prostate cancer screening. The study included over 160,000 men in eight European countries followed for an average of 11 years. The men were randomly assigned to prostate cancer screening with the PSA blood test or no screening. The primary endpoint of the study was death from prostate cancer. The current report in the New England Journal of Medicine gave an additional two years of follow-up data over the prior reports.
As expected with longer follow-up, the benefits from screening have become more clear. The study now shows a 29% decrease in the number of men dying from prostate cancer in the screened group. This confirms the expected benefit for early detection.
This publication comes at a time of great controversy regarding prostate cancer screening here in the United States. Just this year, the US Preventative Health Task Force released their updated recommendation against prostate cancer screening. This recommendation has been attacked by many of us who treat prostate cancer patients. In some states, activism on this topic has led to legislative efforts to prevent insurance companies from refusing to pay for prostate cancer screening. The last thing we want to see is a return to prostate cancer only been detected late in its course when we have little or no chance of curing it.
Obviously, prostate cancer screening is not appropriate for all patients. To benefit from looking for early-stage prostate cancer, a man must otherwise be in good enough health to expect to live at least another 10-15 years. It is not our intention to diagnose every small prostate cancer, especially those in men who would not be likely to benefit from treatment.
The updated results of this European study give us important new information to help us counsel our patients better.