Routine testing for prostate cancer may be harmful

Routine testing for prostate cancer is not recommended for most men as it has uncertain benefits and clear harms, according to an international panel of experts.

However, for some men, such as those with a family history of prostate cancer, discussions about possible harms and benefits of regular screening with their doctor is essential, they said.  

A panel of international experts including those from University of Helsinki in Finland and McMaster University in Canada based their advice on the latest scientific evidence as a part of The BMJ journal's 'Rapid Recommendations' initiative -- to produce trustworthy guidance based on new evidence to help doctors make better decisions with their patients.

The prostate specific antigen (PSA) test is the only widely used test currently available to screen for prostate cancer.

It is used in many countries, but remains controversial because it has increased the number of healthy men diagnosed with and treated unnecessarily for harmless tumours.

So an international panel carried out a detailed analysis of over 700,000 men in clinical trials.

The research found that if screening reduces prostate cancer deaths at all, the effect is very small. The panel advises against offering routine PSA screening and says most men will decline screening because of the small and uncertain benefits and the clear harms.

However, men at higher risk of prostate cancer death -- for example, those with a family history of prostate cancer or of African descent -- may be more likely to choose PSA screening after discussion of potential benefits and harms of testing with their doctor, researchers said.