Prostate cancer test may not cut death rate

The most widely-used test for prostate cancer may not reduce the risk of men dying from the disease, according to research published today.

Substantial numbers of men in the UK ask their GP for a PSA test, in spite of the fact that it only detects abnormalities which may include cancer and if they opt for surgery to remove a prostate tumour they are likely to end up impotent and incontinent. The Department of Health says men should only have the test if they really want it, after advice from their doctor on the pros and cons.

Far more men in the US have a PSA test, which measures levels of prostate-specific antigens in the blood. But the study published today in the US journal Archives of Internal Medicine suggests that having the test may not reduce your risk of dying from the disease.

John Concato from the Veterans Affairs Connecticut Healthcare System in New Haven and Yale University, and colleagues identified 501 men aged 50 and over who had died of prostate cancer from approximately 72,000 older men receiving healthcare. They identified a further 501 who had prostate cancer and had survived, matched for age and treatment at the same healthcare centre.

They found that 70 (14%) of the men who died and 65 (13%) of those who lived had undergone a PSA test. The study, they wrote, "found no evidence of a survival benefit associated with PSA testing or DRE (digital rectal examination)". Based on the available evidence, they said, the PSA test should not be recommended for routine screening of men without symptoms of prostate cancer. The Prostate Cancer Charity in the UK said the results of two trials taking place in Europe and the US were needed to settle the question. "The research published today suggests that we should be looking in other directions for an effective test - one that detects the prostate cancers that might kill if left undetected," said Chris Hiley, head of policy and research at the charity.