Aggressive prostate cancer screening, treatment in this population may have limited survival benefit

-- Monica Smith

Monday, September 13, 2010 (Last Updated: 09/14/2010)

MONDAY, Sept. 13 (HealthDay News) -- Men with low baseline levels of prostate-specific antigen (PSA) at ages 55 to 74 are unlikely to have a survival benefit from additional screening or treatment of prostate cancers, according to research published online Sept. 13 in Cancer.

Pim J. van Leeuwen, M.D., of the Erasmus University Medical Centre in Rotterdam, Netherlands, and colleagues compared the incidence of prostate cancer with prostate cancer-induced mortality as related to PSA levels in 43,987 men, aged 55 to 74 years, enrolled between 1993 and 1999; they also studied an additional 42,503 men in the same age range whose PSA levels were measured between 1994 and 1999. All men had PSA levels below 20 ng/mL at baseline and were followed through 2006.

The researchers found a total of 5,861 prostate cancers during the study period; death rates were highest in those men with the highest PSA levels at baseline. To save one person from death, the number needed to investigate was 24,642 in men with a PSA level of 0.0 to 1.9 ng/mL and 133 for those with a PSA level of 10 to 19.9 ng/mL; the number needed to treat was 724 in those with the lowest levels of PSA, and 60 with the higher levels of PSA.

"The greatest benefits of early detection programs may be when men, aged 55 to 74 years, are diagnosed and treated when their serum PSA level is in the range 4.0 to 9.9 ng/mL or 10.0 to 19.9 ng/mL. Furthermore, the practice of following research that recommends more intensive PSA-based screening by lowering the PSA level cutoff may greatly increase the number of men who need additional investigations and treatment while having little effect on the reduction of prostate cancer mortality," the authors write.

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Specialties Hematology & Oncology
Internal Medicine
Family Practice

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