Prostate Screening Questioned

(Ivanhoe Newswire) -- There is much debate as to whether or not asymptomatic men benefit from regular screening for prostate cancer. A new study lends support to the idea of lengthening the recommended screening intervals to greater than one year.

The study, led by Gerrit Draisma, Ph.D., of the University Medical Center Rotterdam in the Netherlands, indicates more than half of the cancers detected by prostate screening methods would remain undetected for the duration of the patients’ lives without screening. This, researchers say, is an occurrence known as “overdetection.”

Those who oppose screening too often argue that such overdetection may lead to unnecessary treatment in men who would otherwise never be diagnosed with prostate cancer. This is especially disconcerting for the numerous men who experience adverse side effects from the primary treatments used to treat prostate cancer. Some statistics show up to 90 percent experience erectile dysfunction, 50 percent experience urinary incontinence and/or impotence, and 35 percent report bowel problems.

On the opposing side are those who support screening. They argue, “Screen-detected cancers tend to have a favorable stage distribution” and point to decreasing prostate cancer mortality trends following the introduction of prostate-specific antigen (PSA) screening.

Authors of the study say regular screening may advance the date of diagnosis by as much as 10 years and say extending the annual screening age to 75 years could result in two cases of overdetection for every three cancers detected. Therefore, they conclude a screening interval of more than one year is supported but further testing is needed to determine the net balance of favorable versus unfavorable effects of such screening methods.

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.

SOURCE: Journal of the National Cancer Institute, 2003;95:868-878 and 838-839