Overview
- The new Cochrane review published Thursday finds PSA blood-test screening likely prevents about 2 prostate cancer deaths per 1,000 men screened, or roughly one life saved for every 500 men invited.
- Researchers pooled six randomized trials with nearly 800,000 participants and say longer follow-up, including ERSPC data out to 23 years and two recent large trials, revealed a mortality effect that earlier reviews missed.
- Screening detected around 30% more cancers, adding about 36 diagnoses per 1,000 men screened, which raises the risk of overdiagnosis and treatment side effects that can include incontinence and erectile dysfunction.
- The trials did not systematically track quality-of-life harms from biopsies and treatment, and the authors urge shared decision-making rather than universal screening.
- Policy bodies are reassessing guidance, with the UK National Screening Committee expected to revisit its stance this year as experts study targeted approaches that use MRI, biomarkers, and active surveillance to cut unnecessary treatment.