Prostate cancer is one of the leading causes of death in men in Europe
Men who participate in a screening for prostate cancer and are found to have the disease, live longer without symptoms. This is because the cancer in them is detected at an earlier stage and is even less advanced. As a result, the disease has a less negative impact on their lives. This is apparent from research by the Erasmus MC Cancer Institute, the results of which were presented at an International Urology Congress. The researchers argue for the introduction of risk-oriented screening for prostate cancer in all European countries. Such a risk-oriented screening also reduces the chance of overdiagnosis.
Men who are diagnosed with prostate cancer through a screening program live on average a year longer with their disease without it getting worse. If the prostate cancer has already gotten worse, further metastases develop on average two and a half years later than in men who were not screened.
ERSPC
The researchers analyzed data from 43,000 men who had previously participated in a large European scientific study, the European Randomized Study of Screening for Prostate Cancer (ERSPC). It showed that screening by means of a simple blood test (the PSA test) reduces the mortality from prostate cancer by 20 to 35 percent.
Cons
But detecting the disease early also had a negative side. Many cancers were diagnosed that might never have led to symptoms without a diagnosis. Prostate cancer develops very slowly in many men, so that they do not die from the disease, but with the disease. However, the knowledge that they have cancer has a lot of impact on the lives of the men. In addition, they often receive radical treatments. drs. Sebastiaan Remmers (photo), researcher at the Urology department of Erasmus MC: ‘Screening therefore also leads to overdiagnosis and subsequently also to overtreatment.’
Advantages
However, the benefits of screening may outweigh the drawbacks, because the proposed risk-oriented screening significantly reduces the degree of overdiagnosis’, believes Remmers. ‘Longer living in better health is important. Our research also shows another benefit of screening: it can delay – or even prevent, suffering from advanced prostate cancer. That argues for the further development of organised, individualized screening programmes.’
Beating Cancer
The European Association of Urology (EAU) calls for prostate cancer screening to be included in the European Union’s new “Beating Cancer” plan. The EAU recommends a risk-based approach to prostate cancer screening. The screening is tailored to the individual patient. ‘So how often someone needs to be screened depends, for example, on PSA level, family history, ethnicity, gene mutation and prostate size, but also the person’s age,’ says Remmers. ‘Such a systematic and personalized approach reduces the chance of overdiagnosis or overtreatment of cancers that pose a minimal threat.’
obsolete
Arguments against screening have therefore become obsolete due to new developments in both screening and treatment, says co-researcher Monique Roobol. ‘Today we can significantly reduce the detection of low-risk cancers through adequate risk stratification. In addition, in the past, the diagnosis automatically meant radical treatment, such as surgery or radiation, all of which have side effects. Now we have other options for low-risk cancer, such as active surveillance, including MRI scans, that have less impact on quality of life.’
Screening in Europa
Prostate cancer is one of the leading causes of death among men in Europe: number one in Sweden, number two in Germany and number five in many other countries. In the UK, more men die each year from prostate cancer than women from breast cancer. Prostate cancer screening is only organized in a few European countries or regions, including Lithuania and parts of Sweden. Most other countries, including the UK and the Netherlands, do not systematically screen men for the disease for fear of overdiagnosis and overtreatment. However, disorganized screening often only leads to overdiagnosis and overtreatment and has no effect on mortality.
Co-authors of this study are prof.dr. Monique Roobol, department of Urology and ir. Daan Nieboer, departments of Urology & Public Health.
Consult the source and/or provider for more information about this message. News may change, include errors or inaccuracies. Also read our disclaimer and please report messages, reactions and/or images that go against our conditions.
Click on the tags below for relevant posts, if any…