PSA screening benefits at-risk men

Regular prostate specific antigen (PSA) screening may lead to earlier detection of prostate cancer in men whose genes put them at a higher risk, research suggests.

Coloured axial MRI scan of a patient with prostate cancer (Photograph: SPL)
Coloured axial MRI scan of a patient with prostate cancer (Photograph: SPL)

A study published in the British Journal of Urology International showed PSA testing predicted prostate cancer more effectively in men with high-risk BRCA mutations than in the general population.

There is currently no national screening programme for prostate cancer due to a lack of evidence for the benefit of PSA testing.

Mutations in genes BRCA1 and BRCA2 increase the risk of prostate cancer by up to seven- and two-fold respectively.

Researchers analysed data from 300 men aged 40-69 involved in the IMPACT trial.

A total of 205 men with BRCA1 or BRCA2 mutations and 95 non-carriers were offered annual PSA testing. Of these, 24 who had elevated PSA levels were given a follow-up biopsy.

The tests revealed that a higher proportion of mutation carriers had prostate cancer than non-carriers, with diagnosis rates of 3.9% cent and 2.1% respectively.

This translates to a predictive value of 48% for those with the mutations, compared with 24% among non-carriers.

The UK National Screening Committee will issue its next review of the evidence in March 2011.

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