Prostate exam every 4 years misses few cancers

Menstuff® has compiled the following information on the frequency you should use in testing for prostate cancer.

Prostate exam every 4 years misses few cancers

Current guidelines from the American Cancer Society recommend that men over age 50 should be "offered" a prostate exam every year, but data from a European study suggest that a thorough screening for prostate cancer every four years may be adequate.

Testing by measurement of prostate-specific antigen (PSA) in the blood, digital rectal exam (DRE), and transrectal ultrasound (TRUS) will detect most cancers, according to the ongoing European Randomized Study of Screening for Prostate Cancer (ERSPC-Rotterdam).

The rate of occurrence of "interval cancers" -- new cancers that arise between screening visits -- is an "important parameter for determining the sensitivity of the screening procedure and the proper screening interval," Dr. Ingrid W. van der Cruijsen-Koeter and others note in the Journal of the National Cancer Institute.

They determined the rate of interval cancers in over 17,000 men ages 55 to 74 enrolled in the ERSPC-Rotterdam trial. About half the men underwent screening on two scheduled occasions four years apart. The other men -- the control group -- did not receive scheduled screening.

The team checked the Dutch national cancer registry annually for cases of prostate cancer occurring among all participants. The rate of interval cancers was "exceedingly low," the investigators from Erasmus University Medical Center in Rotterdam report.

During the 4-year period, 135 cancers were diagnosed in the control group compared with just 25 in the screened men. Seven of the 25 cancers in the screened group occurred in men who had refused a recommended biopsy at their initial screen, leaving 18 "true" interval cancers.

All of the interval cancers were early stage tumors that had not spread beyond the prostate, suggesting to the team that "very few, if any, aggressive prostate cancers escape screening" with the 4-year interval.


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