PSA testing: press coverage in UK and US is an ocean apartBMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b1287 (Published 27 March 2009) Cite this as: BMJ 2009;338:b1287
- Deborah Cohen, features editor, BMJ
The debate over screening for prostate cancer has been raging since the first prostate specific antigen (PSA) tests appeared 20 years ago. In 2002 Gavin Yamey and Michael Wilkes wrote in the BMJ about the “widespread belief in America” that every man should know his PSA status—a belief, they suggested, that was driven by politics and not evidence (BMJ 2002;324:431, doi:10.1136/bmj.324.7334.431). And despite the publication of two large randomised trials, it looks as though the controversy is far from over.
The studies—one conducted in Europe and the other in the United States—appeared in the New England Journal of Medicine this month, accompanied by an editorial (N Engl J Med 2009;360:1310-9, doi:10.1056/NEJMoa0810696; 1320-8, doi:10.1056/NEJMoa0810084; 1351-4, doi:10.1056/NEJMe0901166).
In the US trial 76 693 men were randomly assigned to receive either annual screening—comprising annual PSA testing and rectal examination—or usual care, which in the US might include screening. The incidence of death was 3.0 in 1000 in the screening group and 2.7 in 1000 in …