Fears prostate cancer screenings may do more harm than good with shocking study showing one in six flagged cases over 15-year trial were wrong

Experts have warned that prostate cancer screenings may be doing more harm than good as a shocking study showed that one is six cases flagged over a 15-year trial were wrong.

It was the largest investigation of the prostate-specific antigen (PSA) blood test – a screening tool used for prostate cancer in some countries across Europe.

The study found that these PSA tests had little impact on reducing the number of deaths and, in some cases, it missed early detection of some aggressive cancers.

The results also indicated that these tests led to worrying numbers of over-diagnosis in patients.

Researchers at the universities of Bristol, Oxford and Cambridge, invited over 400,000 men aged between 50-69 for screenings, with just over half receiving a PSA test.

They kept up with these same men for 15-years and found that nearly seven out of every 1,000 in the group that were invited for screening had died from prostate cancer.

This is compared to nearly eight men out of every 1,000 who had not received a PSA test.

The trial’s results showed that an estimated one in six cancers found by the single PSA screening were an over-diagnosis that led to unnecessary treatment for tumours that were actually harmless.

Treatment for prostate cancer can cause physical side effects such as bladder and bowel problems, erectile dysfunction and, in some rare cases, an infection following a biopsy.

Professor Richard Martin, lead author and Cancer Research UK scientist at the University of Bristol, told the Telegraph: ‘The key takeaway is that the small reduction in prostate cancer deaths by using the test to screen healthy men does not outweigh the potential harms.

‘This results in some men going on to have invasive treatment that they don’t need, many years earlier than without screening, and the test is also failing to spot some cancers that do need to be treated.

‘We need to find better ways to spot aggressive prostate cancers, so we can treat them early.’

Prostate cancer takes 12,000 lives a year, making it the second-biggest cancer killing men in the UK – the first being lung cancer.

It is the most common cancer in the UK without a screening programme, despite the fact that it often shows no symptoms until it has spread and become terminal.

Screenings from prostate cancer are not currently recommended by the UK National Screening Committee (NSC) because they are unclear on whether or not the benefits of screenings outweigh the harms.

Dr Neil Smith, GP for Cancer Research UK and GP Lead for Lancashire and South Cumbria Cancer Alliance, said: ‘With prostate cancer causing 12,000 deaths in the UK every year, we completely understand why men want to know if they have the disease, even when they don’t have symptoms.

‘However, this research highlights that a PSA test for early detection can do more harm than good – it’s simply not accurate enough and can lead to some men having tests and treatment that they don’t need.

‘You know your body best – so if you do notice any unusual changes, contact your GP. It probably won’t be cancer, but if it is, then spotting it earlier means that treatment is more likely to be successful.’

In 2023 Prostate Cancer UK launched the £42m Transform trial, which aims to find out if MRI scans are better at early detection.

Other clinical trials, such as STAMPEDE, are trying to find the best treatment for advanced prostate cancer to improve survival rates and quality of life.

Dr Matthew Hobbs, Director of Research at Prostate Cancer UK, said: ‘A previous trial showed that screening with PSA blood tests does reduce deaths from prostate cancer but that it also misses important cancers and harms men who are given treatments or biopsies they don’t need.

‘The results from the UK CaP trial are extremely significant, because they back up these findings.

‘The number of men screened who still died of prostate cancer in both trials makes crystal clear that the imperative now is to develop, test, and prove new ways to diagnose prostate cancer that detect those aggressive cancers missed by PSA tests and reduce potential harm even further.’