PSA testing and prostate cancer mortality

A striking decline in prostate cancer mortality in the US compared with the UK from 1994 to 2004 coincided with a much higher uptake of prostate specific antigen (PSA) screening in the US. Researchers in the UK found that mortality rates in both countries peaked in the early 1990s, at almost identical rates. However, after this, the rate of decline in the US was almost four times that in the UK. The mean ratio of US to UK age-adjusted prostate cancer incidence rates in 1975-2003 was 2.5, with a pronounced peak around the time that PSA testing was introduced in the US.

Another study investigating the impact of PSA screening in Austria found the expected number of deaths from prostate cancer more than halved in the Tyrol region by 2005, 17 years after PSA screening was introduced.

Collin SM, Martin RM, Metcalfe C et al. Lancet Oncol 2008;9:445-52. Bartsch G, Horninger W, Klocker H et al. BJU Int 2008;101(7):809-16

Originally published in the June 2008 edition of MIMS Oncology & Palliative Care.

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