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New concerns over PSA testing

GPs face more confusion over the Government's screening-on-demand policy for prostate cancer after evidence from a large European study found PSA testing may not be an

effective screening tool.

Researchers conducted two rounds of screening by rectal examination and PSA testing, with a four-year interval, and detected nearly as many cancers in the second round of screening as the first.

Only prostate volume and previous negative biopsy were significantly predictive of the outcome of the second screening tests.

PSA values or rate of change of PSA values were not related to the outcome of

future screening.

Dr Monique Roobol from Erasmus Medical Centre in the Netherlands, presenting the data at last week's American Urological Association meeting, concluded that tests done initially had no predictive value at later rounds of screening.

'It may be more efficient to biopsy on the indication of a combination of predictors at subsequent screening rounds instead of using a fixed PSA value,' she said.

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