As part of the World Chinese Joint Session, organized for the very first time at the EAU Congress, the advantages and disadvantages of PSA screening for prostate cancer were discussed from the European and Asian perspectives. Prof. Per-Anders Abrahamsson (SE) mentioned how early detection can reduce cancer-specific mortality. Dr. Tai-Lung Cha (TW) focused on the dangers of overdiagnosis.
“PSA screening has been a controversial topic for decades and initially Europe was reluctant to implement it,” said Abrahamsson. “Based on new data from big studies I predict that early detection will reduce cancer-related deaths in the future.”
Studies show that men whose PSA level is below 1.0 ng/mL at age 60 have a 0.2% risk of dying from prostate cancer. Abrahamsson advocated for establishing the PSA baseline at age 45. Screening will go hand in hand with improved imaging technology and better treatment techniques.
Cha interpreted the available data from the Asian perspective in his presentation about PSA screening in Taiwan, where cancer-related mortality is relatively low.
Cha warned against overdiagnosis and overtreatment and advised screening should focus on high risk cases. He pointed to the risk of biopsy-related complications, the psychological effects for patients, and the cost-effectiveness of screening and subsequent treatment.
Abrahamsson commented that mortality rates for prostate cancer in Northern Europe are among the highest in the world. He agreed with Cha that, regardless of mortality rates, over diagnosis remains a problem of screening.