Prostate cancer screening: French study finds more harm than good from PSA testing

AMSTERDAM— Organized screening for prostate cancer using the prostate-specific antigen (PSA) test does more harm than good, according to the findings of a French study reported here at the 2013 European Cancer Congress.
With more than half of all French men aged between 50 and 60 having an annual PSA test, Professor Mathieu Boniol PhD, Research Director of the International Prevention Research Institute based in Lyon and his team balanced the side effects and mortality associated with PSA testing against the benefits by using data from the European Randomized Study of Screening for Prostate Cancer (ERSPC) which they compared with published data on the side effects of biopsy and surgery.
The calculation of ‘the number of individuals needed to harm’ associated with PSA was achieved by applying the data to a ‘virtual population’ of 1,000 men aged 55-69 screened using the PSA test and a further 1,000 men not getting the test. The published mortality and side-effect data were then applied to the men being ‘tested’ and a significant down-side of over-diagnosis of prostate cancer — and consequent overtreatment — emerged.
Professor Cora Sternberg, MD, FACP Chief of the Department of Medical Oncology at the San Camillo and Forlanini Hospitals in Rome —who moderated the press conference here on PSA screening — discussed why, she thought PSA testing had not been doing as well as would be hoped in the real world.