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Experts issue call to reconsider screening for breast cancer and prostate cancer
Date:10/20/2009

n men and the second most common cause of cancer death after lung cancer. This year, an estimated 192,280 men will be diagnosed with the disease, and 27,360 men will die from it, according to estimates from the American Cancer Society.

The two diseases account for 26 percent of all cancers in the U.S., with an estimated 386,560 patients diagnosed annually.

Because of remarkable survival rates when the diseases are treated before they spread, screening for both cancers has been promoted on the assumption that early detection and treatment is the best way to reduce deaths. In turn, much of the U.S. population undergoes routine screening for the cancers: About half of at-risk men have a routine prostate-specific antigen test and 75 percent have previously had a PSA test, and about 70 percent of women older than 40 report having had a recent mammogram. More than $20 billion is spent annually screening for the two diseases in the U.S.

The screenings have resulted in a "significant increase" in early cancers being detected, according to the article authors. Because of PSA testing, the chances of a man being diagnosed with prostate cancer have nearly doubled: In 1980, a white man's lifetime risk of the cancer was 1 in 11; today it is 1 in 6. Similarly, a woman's lifetime risk of breast cancer was 1 in 12 in 1980; today it is 1 in 8. And, if ductal carcinoma in situ is included, the risk of being diagnosed with breast cancer, like prostate cancer, has nearly doubled as well.

But the authors found that while deaths have dropped for both cancers over the last 20 years, "the contribution from screening is uncertain." They also found that many patients are undergoing treatment from cancers that actually pose minimal risk.

A comparison of prostate cancer incidence rates in the U.S. to the United Kingdom, where PSA screening has not been widely adopted, "did not result in significant differences in mortality," the authors write. For
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Contact: Elizabeth Fernandez
EFernandez@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
Source:Eurekalert

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