For Release: September 17, 2007
Contact: DMS Communications 603-650-1492
Biopsy, not Screening, Detects Prostate Cancer, Dartmouth/VA Researchers Report
HANOVER, NH—While PSA (prostate-specific antigen) tests have become widely used to screen for prostate cancer, a biopsy is what actually determines the presence of prostate cancer, according to Dartmouth/VA researchers. Nonetheless, it remains unclear whether or not PSA screening reduces prostate cancer deaths.
Nearly a third of prostate biopsies resulted in a cancer diagnosis among a population of older men on Medicare, the investigators reported. Men whose first biopsy did not find cancer often had repeat biopsies later, which increased the chance of a cancer diagnosis in the future.
The study, published online for the September 19 Journal of the National Cancer Institute, was led by Dr. H. Gilbert Welch of the Veterans Affairs Medical Center in White River Junction, VT, and professor of medicine and of community and family medicine at Dartmouth Medical School.
The researchers estimated the proportion of prostate biopsies that result in a cancer diagnosis and the likelihood of finding cancer with subsequent biopsies after the first one was negative. They analyzed the outcomes of 10,429 biopsies performed from 1993 to 2001 in 8,273 men aged 65 and older.
About one third of prostate biopsies detected cancer, and the proportion of biopsies that found cancer increased as men got older. Among men whose first biopsy did not show cancer, about one third of them had another biopsy within five years. Nearly half the men who had a second biopsy were diagnosed with cancer, and the chance of diagnosis increased with each subsequent biopsy.
"Because the goal of screening is to reduce deaths from the disease and not simply to find more cancer, the utility of [repeated biopsies warrant] careful reassessment," the authors wrote.
Co-authors also included Dr. Elliott S. Fisher and Daniel J. Gottlieb, both of Dartmouth. For more information, contact: H. Gilbert Welch, (802) 296-5178.