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PSA testing misdiagnosing men with prostate cancer

By Lilian Anekwe

More than a third of men with raised PSA levels are misdiagnosed with prostate cancer when they actually have benign disease, new findings reveal.

The research suggests PSA testing is not only diagnosing men with prostate cancer who do not require treatment, but wrongly labelling men as having the disease when they actually have benign prostatic hyperplasia.

It reinforces criticisms that prostate PSA testing is swamping GPs and specialists with men who do not require treatment.

Dutch researchers used three mathematical models to predict the extent of over-diagnosis in all prostate cancers diagnosed by PSA tests in the US in men aged 50 to 84 years between 1985 to 2000.

Overdiagnosis ranged from 23% to 42% of all screen-detected cancers depending on the mathematical model used.

The lead time, or the length of time by which PSA screening advanced a prostate cancer diagnosis, ranged from 5.4 to 6.9 years.

The NHS prostate cancer risk management programme recommends GPs provide men who request a PSA test with ‘balanced information' on the risks and benefits of the test, but GPs have had no way of quantifying the likelihood of a misdiagnosis.

Study leader Dr Gerrit Draisma, a researcher in public health at the Erasmus medical centre in Rotterdam, Holland, concluded PSA testing was an ‘imperfect' means of diagnosing prostate cancer.

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