PSA screening and 15-year prostate cancer mortality: Review of the CAP Randomized Clinical Trial

This study looked at whether a one-time invitation for a PSA test for prostate cancer helps men live longer. Over 415,000 men aged 50

to 69 in England and Wales participated in the study . Some were invited to get the PSA test, while others were not. If the PSA results were greater than or equal to 3.0 ng/mL, subsequent diagnostic tests were conducted. After 15 years, the investigators observed that prostate cancer mortality was lower among men who received the PSA test (0.69%) compared with those who did not (0.78%). Thus, a single invitation for PSA testing was associated with a slight reduction in prostate cancer mortality, although the difference was minimal. PSA testing identified a greater number of low-risk prostate cancers, but did not increase the detection of high-risk cases. All-cause mortality was similar in both the screened and unscreened groups. Thus, a single PSA test may modestly reduce prostate cancer mortality over 15 years; however, the benefit is limited and may not improve the detection of more aggressive cancers. However, Dr. Catalona emphasizes that outcomes are expected and have been widely reported with serial PSA screening.

JAMA. 2024 May 7;331(17):1460-1470.doi:10.1001/jama.2024.4011.