Prostate cancer screening may save thousands of lives, study suggests

Time for UK to introduce prostate cancer screening? Routinely assessing men for disease could save thousands of lives, study suggests

• The study saw men screened using a prostate specific antigen (PSA) blood test
• The programme was found to slash cases of advanced diagnosis by 11 per cent
• Experts say it shows widespread screening can help to detect the cancer earlier 
• The findings are likely to reignite debate over whether men should be routinely given the test 

Prostate cancer deaths could be significantly reduced if men were routinely screened for the disease, a study suggests.

Screening men using a prostate specific antigen (PSA) blood test was found to slash cases of advanced diagnosis by 11 per cent, a US study found.

Experts say it shows that widespread screening can help to detect the cancer earlier, giving men a better chance of survival.

The findings are likely to reignite debate over whether men should be routinely given the test, which doctors widely agree is not accurate enough to use for screening.

Screening men using a prostate specific antigen (PSA) blood test was found to slash cases of advanced diagnosis by 11 per cent, a US study found

There is no single test for the prostate cancer in the UK, with a combination of the PSA blood test, biopsies and scans typically used to diagnose the most common cancer among men.

It remains controversial in the US, leading to some men unnecessarily being given aggressive treatments with harmful side effects when they do not have a life-threatening cancer.

The two largest studies of prostate cancer screening to date found conflicting evidence on PSA testing, with one suggesting it reduces risk of dying and another showing it has no benefit.

Researchers from the University of Michigan analysed data involving 5.4million men, comparing screening rates to cases of metastatic cancer – cancer which has spread – in patient records between 2005 and 2019.

PSA screening rates declined from 47 per cent in 2005 to 37 per cent in 2019, across all ages and races.

The proportion of patients who missed screenings for three years in a row also grew, according to findings presented at the American Society for Radiation Oncology (ASTRO) Annual Meeting.

Overall, advanced prostate cancer cases rose from 4.6 cases per 100,000 men in 2008 to 7.9 per 100,000 in 2019, which was attributed to the growing numbers in older age categories.

Of the 128 health facilities, those with lower yearly screening rates had higher rates of advanced prostate cancer, they found.

For each 10 per cent fall in screening, there was a corresponding 10 per cent increase in advanced prostate cancer rates five years later.

When more people failed to attend screening for three years, the number of advanced cancer cases diagnosed went up by 11 per cent.

Dr Alex Bryant, who led the study, said the findings showed that ‘more intensively screening men may be reducing the risk of metastatic prostate cancer later’.

He said: ‘It’s important to gain a deeper understanding of the risks and benefits of screening, because once prostate cancer spreads to other parts of the body, the general thought is that it is at an incurable stage,’ adding: ‘Our results support a benefit in prostate cancer screening in reducing metastatic prostate cancer risk.’

The Daily Mail has been campaigning for more than 20 years for an improvement in treatments and diagnosis of prostate cancer, which kills more than 12,000 men every year.

Men usually only find out they have prostate cancer when they start displaying symptoms.

They then request a PSA blood test from their GP, which they are eligible for after the age of 50.

But PSA has never been deemed accurate enough for a national screening programme.

Initial trials by Imperial College London using MRI scans to detect prostate cancer had showed great promise with a larger study planned.

Simon Grieveson, of Prostate Cancer UK, said the latest findings added to growing evidence that a national screening programme was desperately needed to save lives.

‘The current system is failing these men and so we urgently need a screening programme for prostate cancer that can detect these aggressive cancers early,’ he said.

‘This study builds on the growing body of evidence suggesting the risks associated with screening using a PSA-blood test followed by an MRI scan are now outweighed by the benefits of early diagnosis. 

‘However, we need a large-scale clinical trial to provide the definitive evidence needed to change practice in the UK. 

‘Prostate Cancer UK is committed to supporting this vital study, making screening for prostate cancer a reality and to save thousands of men’s lives.’

WHAT IS PROSTATE CANCER?

How many people does it kill? 

More than 11,800 men a year – or one every 45 minutes – are killed by the disease in Britain, compared with about 11,400 women dying of breast cancer.

It means prostate cancer is behind only lung and bowel in terms of how many people it kills in Britain. 

In the US, the disease kills 26,000 men each year.

Despite this, it receives less than half the research funding of breast cancer and treatments for the disease are trailing at least a decade behind.

How many men are diagnosed annually?

Every year, upwards of 52,300 men are diagnosed with prostate cancer in the UK – more than 140 every day.   

How quickly does it develop? 

Prostate cancer usually develops slowly, so there may be no signs someone has it for many years, according to the NHS. 

If the cancer is at an early stage and not causing symptoms, a policy of ‘watchful waiting’ or ‘active surveillance’ may be adopted. 

Some patients can be cured if the disease is treated in the early stages.

But if it diagnosed at a later stage, when it has spread, then it becomes terminal and treatment revolves around relieving symptoms.

Thousands of men are put off seeking a diagnosis because of the known side effects from treatment, including erectile dysfunction.

Tests and treatment

Tests for prostate cancer are haphazard, with accurate tools only just beginning to emerge. 

There is no national prostate screening programme as for years the tests have been too inaccurate.

Doctors struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment.

Men over 50 are eligible for a ‘PSA’ blood test which gives doctors a rough idea of whether a patient is at risk.

But it is unreliable. Patients who get a positive result are usually given a biopsy which is also not foolproof. 

Scientists are unsure as to what causes prostate cancer, but age, obesity and a lack of exercise are known risks. 

Anyone with any concerns can speak to Prostate Cancer UK’s specialist nurses on 0800 074 8383 or visit prostatecanceruk.org

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