PROSTATE CANCER: Routine Screening Cuts Risk, Study Says
Screening men for prostate cancer on a routine basis "can substantially reduce the deaths from the disease," according to a study released today. The New York Times reports that the study is the "first randomized trial to shed light on a highly controversial question: Does screening apparently healthy men for prostate cancer save lives in the same way that periodic mammograms do for women, or does it merely subject men to treatments for tumors that in many cases would not harm them?" Dr. Fernard Labrie led the study at Laval University in Quebec using 46,000 men, and found that "men who underwent screening had a death rate from prostate cancer less than one-third that of men who were not screened." The Times reports that the "69% reduction in deaths would translate into 27,000 fewer deaths from prostate cancer in the United States each year"(Pollack, 5/19). Labrie said, "If the screening is started ... at the age of 50, diagnosis of metastatic prostate cancer should practically disappear."
Debating The Issue
However, some experts questioned the methodology of the study. "The study is extremely provocative, but it is certainly not conclusive," said Dr. Thomas Finucane of the Johns Hopkins School of Medicine (Maugh, Los Angeles Times, 5/19). According to the Wall Street Journal, researchers "criticized the study because about 23,000 of those invited decided not to participate, leaving behind a group that could have been skewed toward more health conscious men, less likely to be at risk from factors such as smoking or bad diet" (Burton, 5/19). The Times reports that controversy about broad-based screening "stems from the fact that many elderly men develop prostate tumors that grow only slowly, do not spread elsewhere in the body and do not kill." Screening this group of men for prostate cancer could cost as much as $12 million dollars and "subject men to needless surgery or radiation therapy" that could result in other serious complications. "Moreover," experts say that the blood test "used to detect prostate cancer" -- called the prostate specific antigen (PSA) test -- "is not that reliable an indicator of whether a patient has cancer or how advanced the disease is" (5/19).
Weighing The Cost
Dr. Derek Raghavan of University of Southern California's Norris Comprehensive Cancer Center, said, "It would be premature to set national guidelines based on any one study, especially as routine implementation of screening asymptomatic patients will be very expensive to the general community" (Los Angeles Times, 5/19). Labrie said "the cost of mass screening would be $3000 for each cancer case found, less than the comparable costs of mammography for breast cancer detection and Pap smears for cervical cancer detection" (New York Times, 5/19).