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Prostrate screening not really viable

New York, March 19: Prostate cancerdefinedefine screening, supposedly a measure to pick out most vulnerable malignancies, may actually expose men to potentially needless treatments bearing serious complications, results of two studies caution.

While earlier studies strongly recommended an annual screening for PSA (prostate-specific antigen), latest results warn that such test can leave men impotent and incontinent.

The first study, an American trial, analyzed health status of nearly 77,000 men. While half were randomly assigned to undergo regular PSA screening and physical examinations, an open option, to undergo or not to undergo PSA tests, was given to the other group. Only half in the second group went ahead with regular PSA screening.

After seven years of follow-up, 2,820 prostate tumors were detected in the screening group as against 2,322 who went un-screened. While this half of the stats looked positive – the mortality stats proved otherwise. During the seven year study span, 50 men in the screening group died of prostate cancerdefinedefine, as against 44 in the un-screened group.

"When we find prostate cancer, we don't know if it's a killer or a toothless lion — the kind of cancer men will die with, not of," said Dr. Gerald Andriole of Washington University in St. Louis.

Most prostate cancers grow very slowly, and many men with prostate cancer will die of something else before the prostate cancer causes a problem. Ironically, an early detection puts men at risk of unnecessary worry and side effects of treatments, including impotence, incontinence and bowel problems.

Akin to American trail, the second study – a European trial, tracked 1,82,000 men. Although men who underwent PSA screening once every four years were 20 percent less likely to die of prostate cancer than those not tested, over 1,400 had to be tested to prevent one death from prostate cancer.

Furthermore, aggressive treatment, including surgery, offered to 50 patients resulted in one fewer death; the results too bleak to be viable.

"I'm 50 times more likely to receive unnecessary treatment than I am to be the one who avoided the prostate cancer death," Dr. H. Gilbert Welch, researcher at Department of Veterans Affairs, asserted. "From my perspective, that's not a very good gamble."

Overall, both studies fail to prove that regular screening results in fewer deaths from prostate cancer. "Potential side effects of the testing outweigh the potential benefit that the patient may derive from the treatment," the results featuring in the March 18 online edition of The New England Journal of Medicine noted.

According to the American Cancer Society estimates, prostate cancer, the second-leading cancer killer among men after lung cancer, adds nearly 218,000 new cases with over 28000 deaths in the United States each year.

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