Men whose PSA levels were above normal were offered more tests, such as a digital rectal exam and prostate biopsies.
Over 14 years of follow-up, deaths from prostate cancer dropped by 44 percent among the screened men, compared with unscreened men, the researchers found. Overall, 44 of the men who had PSA testing died from prostate cancer, compared to 78 men who had not had been screened.
Among screened men, 11.4 percent were diagnosed with prostate cancer, compared with 7.2 percent of unscreened men. Of the men in the screened group diagnosed with prostate cancer, nearly 79 percent were diagnosed because they took part in the study, the researchers noted.
In addition, men in the screened group were more likely to have their cancer diagnosed while it was in an early stage. In the screened group, 46 men were diagnosed with advanced cancer, compared with 87 men in the unscreened group, Hugosson's team found.
"Our study has a longer follow-up than previous studies, but shows that in those men invited [to the study], the risk of dying is only half of that in the control group. In men younger than 60 at study entry, the effect was even more pronounced -- only one-quarter of expected deaths occurred," Hugosson said.
Moreover, the risk of over-diagnosis was less than previously thought, with just 12 men needed to be diagnosed to save one life. However, since the benefit of PSA screening requires at least 10 years to be borne out, it still seems questionable to test PSA for men over 70, the researchers noted.
Dr. David E. Neal, a professor of surgical oncology at the University of Cambridge in the U.K. and author of an accompanying editorial, believes that, "PSA testing detects prostate cancer early in its natural history when it causes no symptoms. By doing so, it can save the lives of some men who would otherwise have died of the disease."
This study adds to previous evidence that PSA testing and screenin
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