Urologists support single PSA test for men

The PSA test is the best tool available to detect prostate cancer early, Australian experts say.
The PSA test is the best tool available to detect prostate cancer early, Australian experts say.

Australian urologists say a PSA blood test still offers the best hope for beating prostate cancer despite a UK study finding the popular yet contentious screening method did not reduce the number of men who died from the disease over a 10-year period.

A randomised control trial compared the outcomes of single PSA screening with no screening among more than 400,000 men aged 50 to 69.

After 10 years, the total number of prostate cancer cases was higher (4.3 per cent) in the single test PSA screening group compared to the control group (3.6 per cent).

However, the percentage of men dying from prostate cancer in both the groups was the same (0.29 per cent), according to the study published in the Journal of the American Medical Association (JAMA).

The authors concluded the PSA test as a screening method may do more harm than good.

"The results highlight the multitude of issues the PSA test raises - causing unnecessary anxiety and treatment by diagnosing prostate cancer in men who would never have been affected by it and failing to detect dangerous prostate cancers," said Professor Richard Martin, lead author and Cancer Research UK scientist at the University of Bristol.

In a statement on Tuesday, the Urological Society of Australia and New Zealand (USANZ) advised men against avoiding the PSA test.

"The problem is that many of the cancers detected by a population-based approach are of low stage and grade, and it is now well understood that these cancers rarely turn out to be lethal. Therefore, most such cancers are now managed by surveillance rather than up-front treatment," said Professor Shomik Sengupta, USANZ UroOncology Advisory Group Leader.

With more than 3000 men in Australia and NZ dying from prostate cancer every year the PSA test remains the best early detection tool, Professor Sengupta said.

The most important steps to minimising any potential harms of PSA testing follow on after the test.

"Imaging the prostate using MRI scans and targeted biopsies of identified abnormalities help increase the detection of significant cancers and reduce the over-diagnosis of indolent cancers," he said.

Surveillance of low-risk cancers also helps to avoid over-treatment and treatment-related side-effects, Professor Sengupta said

Australian Associated Press