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Cleveland Clinic Study Shows Prostate Cancer Screening Reduces Risk of Developing Advanced Cancer

Patients Treated before PSA Testing Became Commonplace More Likely to Develop Advanced Disease

August 2, 2012

A new Cleveland Clinic study suggests prostate cancer screening decreases a patient’s risk of developing metastatic disease, cancer that spreads beyond the prostate. Patients treated before routine prostate-specific antigen (PSA) screening was advocated had a 10-year metastases-free survival of 74 percent while those treated after routine PSA screening was advocated had an 82 percent 15-year metastases-free survival, according to the study published today in Urology.

“The study shows that routine PSA screening reduces the risk of developing advanced cancer, which is associated with additional treatment-related costs and morbidity,” said Jay P. Ciezki, MD, study author and radiation oncologist in the Taussig Cancer Institute at Cleveland Clinic.

The impact of screening for prostate cancer has been widely debated since 1992 when the use of PSA testing was first advocated in the United States. Opponents of routine screening argue that it has not resulted in a meaningful improvement in survival. In this particular study, researchers from Cleveland Clinic’s Taussig Cancer Institute and Glickman Urological & Kidney Institute determined that a more meaningful way to evaluate the effectiveness of screening was to examine its ability to decrease the development of metastatic disease after treatment.

The study was based on data from more than 1,700 prostate cancer patients who were treated at Cleveland Clinic with either radiation therapy or surgery to remove the prostate gland and surrounding tissues. To assess the impact of screening, the patients were divided into two groups according to when they were treated: a pre-screening era (1986-1992) and a post-screening era (1993-1996). Patients were classified as having high, intermediate, or low-risk disease to determine which groups may have benefited from prostate cancer screening. The 10- and 15-year rates were used to account for changes in the population caused by screening. The benefit of screening was seen across all risk groups.

Prostate cancer is the most common cancer in men, and the second-leading cause of cancer death among men in the United States.

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