Does Cancer Screening Save Lives?

You've heard the message again and again: early screening for cancer saves lives. That simple message is becoming ever more complicated as a growing number of studies indicate that screening may not be the panacea we once thought it was. The latest study to cast doubt on the effectiveness of screening is a follow-up that confirms two 2009 studies that found that men who received regular testing for prostate-specific antigen (PSA) do not live longer than men who don't get regular PSA screening.

The new study, published in the Journal of the National Cancer Institute, use data from an epidemilogical study of 75,000 men who were followed for 13 years.

If the results leave you scratching your head about what to do next, you're not alone.

The controversy over PSA screening is similar to the controversy over breast cancer screening, which I have written about before. It's about the truth you can get from an individual story vs. the scientific evidence from large studies. We all have friends whos lives may very well have been saved because their ancers were detected at an early stage. But when you try to come up with a public health policy that does the most good for the most people, you have to go by the numbers.

In the case of PSA screening, the numbers say there is no statistically significant difference in death rates between men who were screened annually and those hwo weren't.

What should you do? It's the same answer I give to women who are trying to figure out how often to get a mammogram. Talk to your doctor about your specific risk factors and then come up with a screening schedule that works for you.