Searching for answers: prostate screening in a stretched NHS

The UK National Screening Committee is due to review its advice on prostate cancer screening in the next year. At present a national screening programme is not recommended. Prostate specific antigen (PSA) testing can miss cancers while leading to high rates of overdiagnosis, creating treatment harms without benefits to many. But do the benefits of screening now outweigh the potential harms? Some researchers believe they do, thanks to technological advances, but the evidence is still unclear.As Elisabeth Mahase reports this week, earlier this year a non-peer reviewed research abstract suggested that multiparametric magnetic resonance imaging and transperineal guided biopsies reduced the harms of screening (doi:10.1136/bmj.p1062).1 Use of these technologies meant fewer unnecessary biopsies, fewer men developing sepsis during diagnosis, and fewer overdiagnoses of “clinically insignificant cancer.”However, there is still much disagreement among researchers. Although MRI reduces the chance of overdiagnosis, it is not clear by how much, and there isn’t…
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