Prostate Cancer Screening Doesn’t Always Save Lives

Prostate Cancer Screening Doesn’t Always Save Lives

A 23-year study shows early detection in prostate cancer screening doesn’t always “save lives.”

Should public health interventions be judged by their real-world impact? The idea of finding cancer, treating it early to save lives is the mainstay of NHS prostate testing. However, the European Randomized Study of Screening for Prostate Cancer revealed that there is a reduction in deaths due to prostate cancer by approximately 13%. Whilst this is evidence of benefit, it is not as much as might have been anticipated. It is important to note that alongside this, there was no discernable difference in the overall all cause mortality.

Along the way, many men will have come to harm from treatment of prostate cancer (estimated 12 diagnosed for each life saved) and the degree of harm caused by over diagnosis with psychological impacts and over treatment with physical impacts has not been quantified any further.

Whilst long-term follow-up confirms a small reduction in deaths from prostate cancer with PSA testing, those injured cannot be ignored. Future screening strategies should adopt risk-based approaches to minimize over diagnosis while maintaining clinical benefits.