New study adds to controversy over prostate cancer screening

In the latest study examining the controversy over prostate cancer screening, researchers have concluded that screening does not appear to reduce men's risk of dying.

From approximately 72,000 veterans receiving health care at any of 10 VA medical centers in New England, researchers identified 501 men age 50 years and older who were diagnosed with prostate cancer between 1991 and 1995 and had died by the end of 1999.

A comparison group of 501 living men was identified, and each man in this group was matched to a man with prostate cancer who had died. Seventy (14%) of the men who died of prostate cancer and 65 (13%) of the men in the control group were screened with PSA. If PSA screening prevented death, fewer men who died would have received screening compared with the living men, the authors said.

"Optimal clinical strategies for diagnosing and treating prostate cancer remain uncertain and in need of additional investigation," wrote the authors, led by John Concato, MD, of the Veterans Affairs Connecticut Healthcare System, West Haven, and Yale University, New Haven. "Based on available evidence, recommendations regarding screening for prostate cancer should not endorse routine testing of asymptomatic men to reduce mortality. Rather, the uncertainty of screening should be explained to patients in a process of 'verbal informed consent,' promoting informed decision making."

Their research was published in the Archives of Internal Medicine (2006; 166:38-43).