PSA Test in Asymptomatic Men Detects Low-risk Prostate Cancer but Doesn’t Save Lives, Trial Shows

PSA Test in Asymptomatic Men Detects Low-risk Prostate Cancer but Doesn’t Save Lives, Trial Shows
Using a single PSA test to screen men with no symptoms increases detection of low-risk prostate cancer, but does not reduce mortality, results from large U.K. clinical trial show. The study, “Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality The CAP Randomized Clinical Trial,” was published in the Journal of the American Medical Association (JAMA). Prostate cancer is the second most common cause of cancer death in men from the U.S. and U.K., behind lung cancer. U.S. estimates for 2018 predict about 165,000 new cases and over 29,000 deaths from prostate cancer. The PSA test measures the blood levels of the PSA protein, which is often elevated in patients with prostate cancer. Although the test was initially approved in the U.S. to screen asymptomatic patients as well as to monitor disease progression, contradictory results from clinical trials led to different recommendations worldwide. Ongoing debate focuses on the trade-off between reduced mortality rates in patients who undergo screening and the potential harm from over-detection and over-treatment. Although detecting aggressive prostate cancer is crucial and needs to be done as early as possible, diagnosing harmless cancers severely impacts patients’ quality of life. These patients are at risk of infection following a biopsy, and may develop impotence and incontinence due to treatment. To shed new light on this controversy, a research team from the universities of Bristol and Oxford conducted the CAP clinical trial (ISRCTN92187251). They compared the effect of a single PSA test to standard diagnosis with no PSA screening on patients’ mortality over a 10-year period. The research was funded by Cancer Research UK. A total of 419,582 men (189,386 screene
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