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Prostate Cancer Screening No Benefit to Older Men With Low PSA Levels
Date:9/13/2010

andomized Study of Screening for Prostate Cancer in the Netherlands, Sweden, and Finland in 1993 to 1999.

In addition, the researchers also looked at 42,503 men in the same age range from Northern Ireland who had their PSA levels measured between 1994 and 1999.

PSA levels among all the men were under 20 nanograms/milliliter at the start of the study, the researchers noted.

During eight to nine years of follow-up 5,861 developed prostate cancer. The death rates among these men were highest in those with high PSA levels at the start of the study.

For men with PSA levels between zero and 1.9 ng/ml, to prevent one death from prostate cancer, 24,642 men would have to be screened and 724 cases of prostate cancer would have to be treated, the researchers found.

But among men with PSA levels between 10 and 19.9 ng/ml, the benefits of screening and treatment were more reasonable, with 133 men needing to be screened to save one life, researchers said.

"For men with a low serum PSA, the benefits of aggressive investigation and treatment seems to be limited, since they are associated with a large increase in cumulative incidence and potential overtreatment," van Leeuwen said. "The greatest benefits of early detection programs may be when men, aged 55-74 years, are diagnosed and treated when their serum PSA is in the range 4.0-9.9 ng/ml or 10.0-19.9 ng/ml," he added.

Prostate cancer expert Dr. Anthony D'Amico, chief of radiation oncology at Brigham and Women's Hospital in Boston, said that "this is another in a series of studies that are getting at the concern about overtreatment for people who are diagnosed at low PSA levels."

However, two additional factors need to be considered when looking at this study, D'Amico said. One is the overall health of the patient. The other is that the follow-up time is too short to draw any conclusion about young healthy men. To really know if screening for prostate cancer at low PSA levels i
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