NHS CENTRE FOR REVIEWS AND DISSEMINATION
Effectiveness Matters is an update on the effectiveness of health
interventions for practitioners and decision makers in the NHS. It is
produced by researchers at the NHS Centre for Reviews and
Dissemination at the University of York, based on high quality
systematic reviews of the research evidence. Effectiveness Matters is
extensively peer reviewed by subject area experts and practitioners.
The NHS Centre for Reviews and Dissemination is funded by the NHS
Executive and the Health Departments of Scotland, Wales and
Northern Ireland; a contribution to the Centre is also made by the
University of York. The views expressed in this publication are those
of the authors and not necessarily those of the NHS Executive or the
Health Departments of Scotland, Wales or Northern Ireland.
Vol 2, Issue 2, February 1997
■ There is increasing pressure on doctors to
test men for the early detection of prostate
■ Unlike breast cancer screening, which has
been shown to reduce mortality, prostate
cancer screening has not yet been evaluated
and there are several reasons why it may be
■ Many men with prostate cancer never
experience any ill effects because some
tumours are slow growing and not aggressive.
■ The most sensitive screening tests for
prostate cancer are based on levels of
prostate specific antigen (PSA). However, the
PSA test and follow up biopsies cannot
predict reliably whether a man has a cancer
that will progress to cause ill health or death.
■ There have been no reliable evaluations of the
effect of treatments for early prostate cancer
on mortality. Active treatments can result in
major complications such as incontinence
■ There is no evidence on the number of deaths
(if any) which could be averted by screening
asymptomatic men. Screening may lead to
physical and psychological harm resulting
from testing, biopsy and treatment. It is not
known whether screening for prostate cancer
does more good than harm.