Yearly Prostate Cancer Tests May Save Lives
Men Who Get Annual PSA Blood Test Are 3 Times Less Likely to Die From the Disease
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PSA Debate Continues continued...
"What our findings do give us are clues into what I expect the large trials will show," Efstathiou says. "If those studies confirm the results of this trial, annual PSA testing will become standard.
Theodore Lawrence, MD, chairman of the board of ASTRO and chairman of radiation oncology at the University of Michigan School of Medicine in Ann Arbor, agrees.
"There's no question that PSA can detect early-stage prostate cancer, but the question is whether it will improve survival and lower deaths from prostate cancer," he tells WebMD.
There are other problems with the strategy as well, he notes. While cancer causes PSA levels to increase, PSA levels can also rise with benign conditions such as prostate enlargement or benign prostatic hyperplasia (BPH). And even when the PSA increase is due to cancer, the cancer could be so slow-growing as to never be life-threatening.
PSA Screens Linked to Better Prognosis
The researchers studied 1,492 men who were diagnosed with prostate cancer and underwent surgery to remove a cancerous prostate gland between 1988 and 2002. Of the total, 841 men had yearly annual PSA screens before their diagnosis.
The previously screened men fared better on almost every score:
- Their cancers were discovered earlier, when they're more curable, Efstathiou says.
- They were less likely to have aggressive cancers at the time of diagnosis.
- The screened men were at lower risk of relapse or dying after their operation. Only 5% of the screened men had their PSA levels double within three months after prostate cancer surgery, compared with 12% of the other men, Efstathiou says. Having PSA levels double in the three months after surgery is an indication that a person will succumb to the disease in the next 10 years, he says.
ASTRO's Lawrence agrees that the so-called PSA doubling time is a "reasonable surrogate for survival." But it's still a surrogate, not the same as following men to see how many die over time, he says.
Prostate cancer is the second most common cause of cancer death among men, and about 30,000 men die from the disease each year.