Updated results from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial show no evidence that annual screening with the prostate-specific antigen (PSA) test reduces deaths from prostate cancer. These results were published in the Journal of the National Cancer Institute.
The PSA test is sometimes used as a screening test for prostate cancer. The goal of cancer screening is to reduce cancer mortality (deaths) by detecting cancer at an early stage, before symptoms develop. PSA levels tend to be elevated when prostate cancer is present, but levels can also be elevated in benign (non-cancerous) conditions affecting the prostate.
Although the PSA test is widely used, there has been little evidence that routine use of the test reduces deaths from prostate cancer. The risks and benefits of several cancer screening tests, including the PSA test, were evaluated in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. The Study began in 1993 and enrolled people between the ages of 55 and 74 who had no personal history of one of these cancers.
To evaluate prostate cancer screening, more than 76,000 men were assigned to one of two groups: 1) a screening group, which received annual PSA testing for six years and annual digital rectal examination for four years; or 2) a comparison group, in which men received their usual medical care. For some men, usual care included PSA testing.
Study participants have now been followed for 13 years.
- Men in the screening group were 12 percent more likely to be diagnosed with prostate cancer than men in the comparison group.
- The rate of deaths from prostate cancer was similar in the two study groups.
These results suggest that organized, annual screening with the PSA test does not reduce prostate cancer mortality compared with usual care. Results from this study will be reanalyzed after study participants have been followed for 15 years.
Because each person’s situation is different, men may wish to discuss their individual risk of prostate cancer and need for screening with their physician.
Reference: Andriole GL, Crawford ED, Grubb RL et al. Prostate cancer screening in the randomized Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial: Mortality results after 13 years of follow-up. Journal of the National Cancer Institute. Early online publication January 6, 2012.
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