March 19, 2009
Does Early Detection Of Prostate Cancer Help?

Early detection of prostate cancer doesn't help when you have 7 to 10 years left to live due to old age.

Results released today from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial show that six years of aggressive, annual screening for prostate cancer led to more diagnoses of prostate tumors but not to fewer deaths from the disease. The study, led by researchers at Washington University School of Medicine in St. Louis and conducted at 10 sites, will appear online March 18 in the New England Journal of Medicine (and in the journal's print edition on March 26).

"The important message is that for men with a life expectancy of seven to 10 years or less, it is probably not necessary to be screened for prostate cancer," says the study's lead author and principal investigator Gerald Andriole, M.D., chief urologic surgeon at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital.

Prostate cancer is a slow killer for most men. So this result isn't entirely surprising. Someone getting a diagnosis of prostate cancer when they have 5 years till their heart gives out is probably going to die from heart failure, not prostate cancer. The researchers of this study think that their younger enrollees might eventually show that early detection will help them live longer.

A European study with a longer running history finds that early detection of prostate cancer does extend life expectancy.

Screening for prostate cancer can reduce deaths by 20%, according to the results of the European Randomized Study of Screening for Prostate Cancer (ERSPC) published online 1700 hours CET, today 18 March (NEJM, Online First*). ERSPC is the world's largest prostate cancer screening study and provides robust, independently audited evidence, for the first time, of the effect of screening on prostate cancer mortality.

The study commenced in the early 1990s involving eight countries Belgium, Finland, France, Italy, Netherlands, Spain, Sweden and Switzerland - with an overall follow-up of up to 12 years. Participants totalled 182,000 but then narrowed down to 162,000 men in seven countries, aged 55-69; only those who had not been screened could take part. The findings are being unveiled at the 24th Annual Congress of the European Association of Urology (EAU) in Stockholm, Sweden (17 - 21 March 2009).

By initially screening men 55 to 69 years with the PSA marker and offering regular follow up, this led to an increase in early detection. Deaths due to metastasized disease were then reduced. Exact data showed that on average for every 1,408 men screened, 48 had cancer diagnosed and received treatment, resulting in saving one life. Screening took place on average every four years with a mean follow-up over nine years. The cut-off value was a PSA level of 3.0 ng/ml or more. Men with this reading were then offered a biopsy.

What would extend life expectancy much more assuredly: cures for cancer. In the mean time while we wait for cures eat more mushrooms.

Share |      Randall Parker, 2009 March 19 11:32 PM  Aging Cancer Studies

Jake said at March 20, 2009 4:52 AM:

The non testing idea is great in theory, but prostate cancer is one of the most painful way to die there is. I will always get the test. Prostate cancer is a Vitamin D deficiency disease. Get your Vitamin D level to 70 and you won't have to worry.

Ned said at March 20, 2009 6:24 AM:

No real surpirses here. It's said that prostate cancer takes 10-20 years to kill you, so screening for the disease in mea with a life expectency less than that doesn't make sense. The European study used a PSA level 0f 3.0 ng/ml for intervention, while most Americans use 4.0 ng/ml. The lower cutoff will find a few more cancers but also cause many more benign biopsies. Still, in 2008, an estimated 28,660 American men died of prostate cancer, second only to lung cancer. So, for now, digital rectal examination and PSA levels in men over 50 (or over 40 if there is a family history) with a life expectency of at least ten years are all we have to battle this disease through early detection.

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