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Prostate cancer screening practices examined

St. Louis, Mar. 15, 2005 -- Initial results from an ongoing study evaluating the benefit of prostate cancer screening practices demonstrate that the combined use of both standard tests--the prostate-specific antigen (PSA) blood test and the digital rectal exam (DRE)--is optimal for detecting cancer.

The initial results also confirm that the design of the massive study, which will continue until 2019, will indeed allow researchers to determine whether current screening practices reduce death from prostate cancer, according to the authors. They present their analyses in two papers, one in the March 16 issue of the Journal of the National Cancer Institute and the other in the March issue of the Journal of Urology.

The study is part of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial being conducted by researchers at Washington University School of Medicine in St. Louis and several other institutions.

Uncertainty about the need for prostate cancer screens stems from several factors. PSA and DRE tests can be inaccurate, giving both false negatives and false positives. In addition, neither test indicates how aggressive a man's cancer is. Furthermore, because prostate cancers grow slowly in many cases and treatments can have unpleasant side effects, treating the cancer may be less desirable than leaving it alone, especially in older men.

"But the main thing is we don't know whether screening saves lives," says Gerald L. Andriole Jr., M.D., head of the Division of Urologic Surgery at Washington University and Barnes-Jewish Hospital. "Our study follows about 75,000 men, half of whom we are screening, and half of whom are getting conventional care. By comparing groups over the long term, we will see what difference screening makes in survival rates."

Begun in 1993, the PLCO study has screened 34,244 men across the United States, aged 55 to 74, for prostate cancer and followed their subsequent med
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Contact: Gwen Ericson
ericsong@wustl.edu
314-286-0141
Washington University School of Medicine
15-Mar-2005


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