Prostate cancer overdiagnosis attributed to PSA test

Since its introduction in 1986, PSA screening has resulted in more than one million men being needlessly diagnosed and treated for prostate cancer, according to a study published online Aug. 31 in the Journal of the National Cancer Institute.

Using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program, researchers at the White River Junction VA, the Dartmouth Institute for Health Policy & Clinical Practice, and the University of Connecticut examined age-specific prostate cancer incidence rates from the U.S. Census to determine the excess or deficit in the number of men diagnosed and treated for prostate cancer each year since 1986.

According to the researchers, overall incidence of prostate cancer rose rapidly, peaked, and declined to levels considerably higher than in 1986. Regardless of age, an additional 1.3 million men were diagnosed who would otherwise not have been diagnosed without PSA screening, and more than one million have been treated since 1986.

"Given the considerable time that has passed since PSA screening began, most of this excess incidence must represent overdiagnosis," the authors wrote. "All overdiagnosed patients are needlessly exposed to the hassle factors of obtaining treatment, the financial implications of the diagnosis, and the anxieties associated with becoming a cancer patient."

The increased diagnosis has been most dramatic among younger men: more than tripling since 1986 in men aged 50 to 59 years (from 58.4 to 212.7 per 100,000) and more than a sevenfold increase in men under age 50 (from 1.3 to 9.4 per 100,000).