Australasian Science: Australia's authority on science since 1938

Why No Man Should Take a PSA Blood Test for Early Stage Prostate Cancer Without Reading This

By Ian Haines

Men with early-stage abnormalities of the prostate who are monitored for any progression of the cancer live just as long as men who opted for complete removal of the prostate and now live with the immediate consequences.

The full text of this article can be purchased from Informit.

From the 1980s, when prostate screening became available, many men over 40 without symptoms were diagnosed with early stage prostate cancer. However, most prostate cancers take decades to reveal themselves, and most men will die with, but not from, prostate cancer.

Autopsy studies reveal prostate cancer in up to 40% of men in their forties and 65% in their sixties, but only 3–4% of Australian men actually die of prostate cancer at a median age of 82. So why would any man agree to a PSA test and then a biopsy and radical treatment?

Hard evidence against such drastic steps is strong. In the UK’s ProtecT trial, three groups of men experienced either surgical removal of the prostate (553 men), radiation treatment (545 men) or active monitoring (545 men). After 10 years, the total number of deaths due to any cause was 55, 55 and 59, respectively.

Although surgery delayed the development of secondary cancers in a small number of men, the number of deaths definitively attributable to prostate cancer in each group was low – only three, four and seven deaths, respectively – so the odds of dying specifically from prostate cancer in the first 10 years is in the order of 1%, with no survival advantage for treatment.

In a second PIVOT study from the US, two groups of men experienced either surgical removal of the prostate (364 men) or active monitoring (...

The full text of this article can be purchased from Informit.