In November, 2011, the U.S. Preventive Services Task Force recommended against prostate-specific antigen (PSA) blood test screening for prostate cancer in healthy men. The task force said the potential risks of PSA testing outweigh the potential benefits, and said “there is little evidence PSA testing saves lives but rather that many men instead suffer from impotence, incontinence, heart attacks related to treatment of tiny tumors that would never kill them.”
The recommendation sparked a controversy, and a group of prominent urologic oncologists published a strongly dissenting opinion. At the center of this controversy is data which strongly suggest that the problem is not with the PSA test itself, but with the current inability to distinguish between indolent (non-lethal) and aggressive (lethal) disease once the tumor has been confirmed by needle biopsy. Because of this, the vast majority of most men diagnosed with the prostate cancer are being treated as though they have aggressive prostate cancer. The cost of these unnecessary treatments is estimated to be $2.6 billion annually.
In this study, the researchers aim to develop a new prognostic test, based on the expression of microRNA, to distinguish between aggressive and indolent prostate cancer. Using small tissue samples collected via a biopsy with a hollow “core” needle, the test will be able to identify patients with indolent prostate cancer. This information can provide physicians and patients with more complete information when making decisions about long-term therapeutic strategies. Such a test could have a major impact on the clinical management of prostate cancer, and significantly reduce the number of patients receiving unnecessary overtreatment of indolent prostate cancer. This, in turn, could save lives and reduce the overall health care costs for treating prostate cancer.