The effect of low-intensity PSA-based screening on prostate cancer mortality
This research was undertaken by researchers at the University of Bristol using administrative data made available via the Office for National Statistics (ONS) Secure Research Service (SRS), which is being expanded and improved with ADR UK funding.
This research investigates whether inviting men aged 50-69 for a single prostate specific antigen (PSA) test would help detect high risk cancers earlier, and if early treatment of these cancers would result in longevity. It was led by Professor Richard Martin and Dr Emma Turner of the University of Bristol.
Researchers specifically used ONS microdata on mortality and cancer registrations, including Hospital Episode Statistics; inpatient, outpatient, and Accident and Emergency datasets, obtained for men based in centres in England, and Patient Episode Database for men in Wales. The team recruited 408,825 men in the prostate cancer trial: 46% of those men were invited to have a one-off PSA test, while 54% were not invited for a screening. All participants were then followed up across 10 years.
This research found that 10,000 men need to be screened to save one life. This innovative trial provides new evidence to inform the balance of benefits and harms of screening for prostate cancer. Of every 1,000 men who received a PSA test, 43 were diagnosed with prostate cancer, and 30 in 10,000 men died because of prostate cancer. Of every 1,000 men who were not invited for a PSA test, 36 were diagnosed with prostate cancer, and 31 in 10,000 men died because of prostate cancer. This research can help avoid unnecessary harm to men and save the NHS up to £1 billion a year in screening and follow up in treatments.
The findings of this research are currently used by parliamentarians in the UK, Sweden and the United States, and has been disseminated across newspapers and radio programmes, websites and blogs.