New study shows screening modestly reduces prostate cancer deaths
MINNEAPOLIS/ST. PAUL (5/27/2026) — A new systematic review co-led by a University of Minnesota Medical School researcher found that blood tests to detect potential signs of prostate cancer likely reduce the risk of dying from prostate cancer. The findings were published in the Cochrane Library. This is a shift from the previous version of the review, which did not find sufficient evidence that screening reduced prostate cancer deaths.
Prostate cancer is one of the most common cancers in men. Early detection through screening has long been debated, with experts divided on whether the benefits outweigh the risks of overdiagnosis and overtreatment.
A modest but meaningful benefit
The review team analyzed data from six trials involving almost 800,000 participants across North America and Europe. They found that screening with a prostate-specific antigen (PSA) blood test reduces prostate cancer deaths by approximately 2 for every 1,000 men screened. Put another way, 500 men would need to be invited to a screening to prevent one prostate cancer death.
“With new data now available, we can now say with moderate certainty that PSA screening reduces prostate cancer deaths in men with a sufficient life expectancy,” said Philipp Dahm, MD, professor at the University of Minnesota Medical School. “This suggests that for the right patient – someone who is well-informed, has a good life expectancy, and understands the full implications of screening – there is now a reasonable evidence base to support a conversation about PSA screening. This represents an important change in the evidence for future guideline developers and policy makers to consider.”
The review also found little evidence that screening affects quality of life or causes significant harm through biopsy or treatment-related deaths. However, researchers acknowledge that data on wider harms, such as complications from biopsies, sexual dysfunction and urinary problems, were insufficiently assessed in the included trials.
However, the risk of overdiagnosis still remains a key issue. Screening detected around 30% more prostate cancers overall, mostly at an earlier stage. The review found that roughly 36 additional cancers were diagnosed per thousand men screened, for every 1–2 deaths prevented. The authors caution that these tests can detect low-grade cancers that may never have caused symptoms or harm during a man’s lifetime, meaning identifying them can cause anxiety and unnecessarily aggressive treatment.
“We want to be clear that this is not a blanket endorsement of universal screening,” said first author, Dr. Juan Franco from Heinrich Heine University Düsseldorf. “The decision should always be made between a patient and their doctor, with a full understanding of both the potential benefits and the very real risks of overdiagnosis and unnecessary treatment.”
Better data, stronger evidence
This review updates a previous version first published in 2006 and last revised in 2013. Produced with support from the Cochrane Editorial Group, Cochrane Urology is based at the Minneapolis VA Medical Center and the University of Minnesota and is part of a global network of researchers and clinicians dedicated to producing high-quality, independent systematic reviews that guide evidence-based decision-making in urological care. The 2013 review concluded that prostate cancer screening did not significantly reduce prostate cancer mortality, based on a meta-analysis of five randomized controlled trials. That uncertainty played a major role in several countries deciding against implementing national screening programs.
The authors state that the modest benefits observed in this review aren’t due to changes in the underlying evidence but mostly because the trials have now followed participants for long enough to detect a mortality benefit that was previously too early to see.
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About the UMN Department of Urology
The University of Minnesota Department of Urology has been at the forefront of urologic patient care, research, and education for more than 90 years. Building on a rich history of excellence, we continue to lead innovative efforts across key areas of urology, including cancer, stone disease, infertility, and pediatric care. Through world-class education and training programs, we prepare the next generation of urologists to deliver comprehensive, coordinated, and patient-centered care. Committed to our values, we strive to be inclusive of all people, innovative in advancing clinical care, teaching, and research, and an inspiration to patients, learners, and colleagues alike, embodying our mission to be I3: Inclusive, Innovative, and Inspirational.