Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

PSA screening concerns

Routine screening for prostate specific antigen (PSA) in men is not currently recommended in the UK and it would seem that this position may be justified given some recent results from the European Randomised Study of Screening for Prostate Cancer (ERSPC). These results have been reported in the general media (BBC).

ESRPC is a study that is aiming to assess the risks and benefits of prostate cancer screening with data from 8 European countries. This latest data come from the Finnish arm of the study shows that for every 8 men screened in a four year period, one would get a false positive result that would require further investigations that were likely to be unnecessary. Additionally, these individuals were twice as likely to disengage from future screening.

The BCC article quotes the study lead, Dr Tuomas Kilpelainen: "I don't think routine screening should be advised until more is known on the adverse effects and costs of screening". Men with urinary tract symptoms who are worried about prostate cancer are still encouraged to seek medical help.

Action: Clinicians should be aware of these results. Selective screening of PSA in men with urinary tract symptoms may be appropriate after discussion of the pros and cons.

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