Prostate cancer: PSA test for early detection?
More than 6,000 men are diagnosed with prostate cancer every year in Switzerland. The PSA test is one method of early detection, but is this blood test a helpful option? We provide the information so you can make up your mind.
PSA stands for “prostate-specific antigen”, a protein that is only produced by cells in the prostate gland and can be measured in the blood. A raised PSA level in the blood may indicate that there is a problem with the prostate gland. However, PSA testing can also cause false alarms and unnecessary treatment. As a result, opinions are sharply divided as to whether or not this test should be carried out.
Is the PSA test helpful?
The Harding Centre for Risk Literacy at the University of Potsdam has summarised the benefits and risks of PSA testing for the early detection of prostate cancer based on scientific studies. In five long-term studies, men aged 50 years or older either participated or did not participate in regular PSA testing. After around 16 years, the participants and non-participants were compared.
Effect on mortality rate
Across both groups, a total of 322 in 1,000 men died. Of these, 12 in 1,000 men who did not have early detection and 10 in 1,000 men who did have early detection died of prostate cancer.
False positives
155 in 1,000 men who took part in PSA testing received an abnormal test result that subsequently proved to be a false alarm. However, finding this out usually requires a biopsy, which involves removing tissue from the prostate.
Overtreatment
51 in 1,000 test participants were diagnosed and treated at least once for non-progressive prostate cancer that would never have caused any problems during their lifetime. This is referred to as overtreatment. As unnecessary treatment for non-progressive prostate cancer can also cause impotence and incontinence, the test exposed these men to health risks.
Early detection was able to save 2 in 1,000 men from dying from prostate cancer. However, regardless of the cause of death, no fewer men died than in the group without the PSA test. Of the men who took part in early detection, some were alerted to an apparent issue for no reason and some were diagnosed with non-progressive cancer and treated unnecessarily.
In light of these facts, it is ultimately up to each individual to decide whether or not to undergo PSA testing. We hope you now have a clearer overview of this complex issue.
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