Can screening for prostate cancer with a PSA test help save lives? – Cancer Research UK

The earlier cancer is diagnosed, the better. That's because there are generally more treatment options if the tumor is not very large or has not spread.

One way to help diagnose cancer early is through screening programs. This is when people who have no symptoms of cancer are tested for cancer.

There are currently three Screening program in the UK, for breast cancer, colorectal cancer, and cervical cancer. These programs help save thousands of lives each year. The UK is also in the process of introducing a new system. Targeted lung cancer screening program For people at high risk of illness.

But why aren't there any screening programs for prostate cancer? Here's a look at some of the latest research on PSA testing.

What is a PSA test?

A PSA test measures the amount of prostate-specific antigen (PSA) in your blood. PSA is a protein made by both normal and cancerous prostate cells.

It is normal for all men to have some amount of PSA in their blood. High levels of PSA can be a sign of prostate cancer, but other conditions, such as a urine infection, can also raise PSA levels.

It is important to note that the diagnosis of prostate cancer is not based solely on PSA levels. Instead, the PSA test will help doctors decide whether to perform further tests on her, such as an MRI scan or a biopsy.

Why is the PSA test not used for prostate screening?

You may have heard someone suggest using the PSA test to screen for prostate cancer. You may also know someone who took a PSA test when they were asymptomatic.

However, the UK National Screening Committee (NSC), an independent organization that reviews evidence for screening programmes, currently does not recommend PSA testing for prostate screening as the harms do not outweigh the benefits.

That's because the PSA test isn't reliable or accurate enough to detect prostate cancer. This means it may miss some cancers (false negatives) or suggest that people who don't have cancer have cancer (false positives). It may also lead to overdiagnosis.

The problem of overdiagnosis

Not all prostate cancers are the same. Some grow quickly and spread quickly, while others grow slowly. Some of these cancers grow so slowly (or not at all) that they do not cause any problems if undetected and, if left untreated, can cause a person to develop cancer. will not be harmed by.

When such harmless cancers are discovered, they are said to be “overdiagnosed.”

Because it is impossible to distinguish between potentially harmful and harmless prostate cancer, men diagnosed with prostate cancer are usually offered treatment. Therefore, in some cases, men are unnecessarily treated for prostate cancer that would otherwise not be harmful.

These treatments can have serious impacts on people's lives, including the possibility of infection after a biopsy and erectile dysfunction and bladder problems after treatment.

What does the latest research show?

The CAP trial is the largest prostate cancer screening study to date. More than 400,000 men aged 50 to 69 from around 600 GP practices across the UK took part.

A 15-year follow-up of the study was recently conducted. Published in the American Medical Association (JAMA). This study found that inviting asymptomatic men once for a PSA blood test had little effect on reducing prostate cancer deaths, reducing the death rate by less than 1 death per 1,000 men invited for screening. It turned out to be.

The study results also showed that an estimated one in six cancers detected by a single PSA screening were overdiagnosed, potentially leading to unnecessary and invasive treatment. .

In the years since this trial began, diagnosis and treatment of this disease have improved. Introduction of MRI before biopsy. These changes may help prevent some of the harms associated with PSA testing, but more research is needed on how to find aggressive cancers that require treatment.