Routine Prostate Screening Reduces Mortality
The European Randomized Screening for Prostate Cancer Study: A Summary
Colin Rice, Prostate Cancer Awareness Grant Coordinator
Planned Parenthood of Amarillo and the Texas Panhandle
8 October, 2008
Prostate cancer is a leading cause of cancer deaths in much of the industrialized, western world.1 There are many different speculations as to the cause of higher incidence and mortality rates in western countries, ranging from dietary factors such as high animal fat intake and a sedentary lifestyle to biological factors, as indicated by the higher mortality among African Americans and Caucasians when compared to their peers of Hispanic or Oriental descent.2 Many countries in Europe have begun an aggressive and highly documented and analyzed campaign to promote prostate screening, and the plethora of results published indicate that there is, indeed, a benefit to routine screening.
were also less likely to exhibit high-risk features of prostate cancer, including an overall lower prostate volume and lower PSA levels. 3
Similar results were found in other branches of the ERSPC study. The branch of the study conducted in Rotterdam, the Netherlands, consistently found that, under the same methods, only 7 patients from the screening group were diagnosed with metastatic disease, compared with 27 in the control group.4 A similarly constructed Quebecois study infers lower mortality in men who are actively screened; and yet another early detection program carried out in the state of Tirol, Austria, credits the combination of early screening and availability of treatments with a 33% reduction in prostate cancer mortality when compared to the rest of the country.5,6
Many doctors are hesitant to routinely screen their at-risk patients for prostate cancer, and some commonly cited excuses are the lack of research proving its necessity and the associated cost of widespread screening. While continuing research by the ERSPC validates the preventative benefits of active screening, an independent Swedish study was performed analyzing the costs associated with diagnosing early prostate cancer.
This study found that the average cost per case of prostate cancer that was diagnosed early was 37% of the cost of a case of prostate cancer that developed and required potentially curative treatment at time of diagnosis.7 Incorporating this active screening with shared decision making on the part of the doctor and patient can greatly reduce the financial and health burdens presented by prostate cancer by enabling both the doctor and the patient to make proactive decisions to control the disease in its early stages.