english.prescrire.org > Spotlight > Archives : 2013 > Self-screening for prostate cancer: ban in France is justified

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Self-screening for prostate cancer: ban in France is justified

Screening for prostate cancer by measuring PSA levels presents an unfavourable harm-benefit balance.

Measuring the level of the prostate specific antigen (PSA) in the blood is used in prostate cancer screening. In September 2012, the French Health Products Safety Agency banned the sale of PSA self-testing kits in France. Used in a non-medical environment, particularly in the home, these tests measure PSA levels in the blood from a drop of capillary blood.

Independently of the performance of self-tests, the clinical benefits of prostate cancer screening based on PSA levels have not been proven, whatever the person’s age. Its effect on prostate cancer mortality is at best minimal, and it has no effect on overall mortality. But its adverse effects are proven.

Around 70% of participants whose PSA levels are considered abnormal have no cancer. Apart from the anxiety caused, they are exposed to the potentially serious adverse effects of a prostate biopsy to confirm the diagnosis, especially complications resulting from infection.

Often, screening leads to overzealous diagnosis, i.e. the discovery of cancers whose natural development would not have compromised the health of those concerned. And yet the treatment of these cancers exposes the patient to urinary incontinence, erectile dysfunction etc.

For men considering prostate cancer screening, it is better for the healthcare professional to provide balanced information on its dubious efficacy and sometimes harmful consequences.

©Prescrire 1 September 2013

"PSA home tests: ban in France is welcome" Prescrire Int 2013; 22 (141): 218. (Pdf, subscribers only).

Download the full review.
Pdf, subscribers only

For more information::

Prostate cancer:
too many adverse effects
from PSA-based screening
(September 2012)

Routine screening
for prostate cancer
is not justified
(November 2009)