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PSA and Prostate Cancer | Blog | County Pathology Ltd

PSA and Prostate Cancer

PSA

PSA Tests Cut Metastatic Prostate Cancer Rate by 50%
Screening for early prostate cancer detection may reduce the rate of related metastatic prostate cancer In a study today in the New England Journal of Medicine.

The incidence of metastatic prostate cancer fell by approximately 50% within 7 years of the start of widespread PSA use in 1990

For individuals aged 40 years and older, the median age at diagnosis has fallen from 71.8 years to 69.8 years for advanced prostate cancer — a difference of 2 years.

Dr Welch and colleagues looked at the incidence of metastatic disease for prostate cancer using the Surveillance, Epidemiology, and End Results (SEER) Program database for incidence of initial diagnoses of metastatic disease, not early-stage disease that progressed to metastasis.

Although the authors speculate that interventions to reduce prostate cancer risk or reductions in environmental carcinogens might contribute to a reduction in the incidence of prostate cancer, they believe that "it's hard to imagine another factor [other than PSA screening] changing and exerting an effect so quickly."

Prostate cancer expert Anthony V. D'Amico, MD, PhD, of the Brigham and Women's Hospital and Dana Farber Cancer Institute, Boston, who was not involved with the new essay, agreed.

"The initial spike in all prostate cancer incidence following PSA screening was due to the test identifying all the undiagnosed clinically occult disease missed on digital rectal examination, earlier detection of prostate cancer means that diagnosis of metastatic disease at presentation is less likely to occur," Dr D'Amico said.