Medscape Medical News | August 15, 2012
A new approach to evaluating the benefits and harms of prostate-specific
antigen (PSA) testing "shows the way to a resolution of the
long-standing problem about screening for prostate cancer," according to
an editorial in the August 16th edition of The New England Journal of Medicine.
The new study, which is derived from statistical modeling, found that
the benefit of prostate cancer screening is "diminished" by the loss of
quality-adjusted life-years caused by overdiagnosis and
overtreatment.
Nevertheless, there is an average net benefit from screening in terms
of quality-adjusted life-years, according to the study authors, who are
led by Eveline Heijnsdijk, PhD, of the Erasmus Medical Center in
the Netherlands.
Annual screening of those between the ages of 55 and 69 years would result in:
- 9 fewer deaths from prostate cancer (28% mortality reduction);
- 14 fewer men receiving palliative therapy (35% reduction);
- a total of 73 life-years gained (an average of 8.4 years per prostate cancer death avoided).
However, the total number of quality-adjusted life-years gained from
screening in the group was lower (56 years) than the unadjusted (73
years) because of harms that men endure due to screening, they
report. Screening would also result in 45 men being overdiagnosed and
overtreated.
The authors calculated that to prevent one prostate cancer death, 98
men would have to be screened and 5 cancers would have to be detected.
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