WASHINGTON (dpa-AFX) - Men who consistently skip prostate cancer screening appointments face a significantly higher risk of dying from the disease, according to new research identifying a high-risk group.
'Our study identifies that men who were invited for screening, but do not attend screening appointments are at significantly higher risk of dying from prostate cancer compared to men who were not offered screening or accepted an invitation for screening,' said study's lead author, Renee Leenen, a Ph.D. researcher in the group of Professor Monique Roobol at the Erasmus MC Cancer Institute.
Findings from the European Randomized Study of Screening for Prostate Cancer (ERSPC), the world's largest prostate cancer screening study, were presented at the European Association of Urology (EAU) Congress in Madrid. The study analyzed data from seven countries, offering new insights into the long-term impact of screening avoidance.
A sub-analysis of 20-year follow-up data from the ERSPC is the first to examine the link between repeatedly declining screening invitations and prostate cancer mortality.
The study, which included 161,000 men aged 55-69 across Finland, the Netherlands, Italy, Sweden, Switzerland, Belgium, and Spain, highlighted the potential consequences of avoiding screening.
Led by researchers from the Department of Urology at Erasmus MC Cancer Institute, University Medical Center Rotterdam, the analysis found that among 72,460 men invited to screening, over 12,400 (one in six) never attended. This group had a 45 percent higher risk of dying from prostate cancer compared to those who participated in screenings.
'It may be that men who opted not to attend a screening appointment are care avoiders, meaning they're less likely to engage in healthy behaviors and preventative care in general. This is the opposite behavior of people who are perhaps more health-conscious and are more likely to attend a screening appointment,' Leenen noted.
'We need to better understand who these men are, why they choose not to attend appointments, and how to motivate them. This will help us to design population-based prostate cancer screening programs that encourage higher rates of informed participation. Tackling attendance rates in this way could be a big factor in the long-term success of a national prostate screening program.'
When compared to a control group, which included men who were never invited to screening, those who attended had a 23 percent lower risk of prostate cancer death. In contrast, non-attenders faced a 39 percent higher risk of dying from the disease.
These findings underscored the critical role of regular screenings in reducing prostate cancer mortality.
'For countries around Europe that are planning to introduce a national prostate screening program, this analysis focusing on attendance shows that men who participate in screening have a much-improved long-term benefit than what we've seen from previous studies,' said Dr. Tobias Nordström, Clinical Urologist at the Karolinska Institute in Sweden, and Member of the EAU Scientific Congress Office.
'But it highlights a group of men who need our attention, as they're more at risk of developing advanced prostate cancer and dying from it. We need to better understand why these men might actively choose not to participate in screening, despite being invited to attend, and how this behavior is linked to worse outcomes when they get a diagnosis.'
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