Going to screenings may lower death risk from prostate cancer by 23%

Going to screenings may lower death risk from prostate cancer by 23%

Prostate cancer is the most commonly diagnosed cancer among men in 112 countries, and its prevalence is projected to double by 2040.

Nationally implemented screening programs that measure prostate-specific antigen (PSA) levels in the blood could offer men earlier access to treatment, improving their chances of a cure and reducing the need for expensive treatments linked to advanced-stage disease.

Long-term data consistently show that PSA screening can lower the risk of dying from prostate cancer by 20%.

In this new research, from the world’s largest prostate cancer screening study, however, researchers looked at 20 years of data to see how often saying no to prostate cancer screening affects the chances of dying from the disease.

Based on 20 years of data from over 160,000 men across seven European countries, the study highlighted a high-risk group often overlooked in national screening efforts: appointment avoiders.

The study’s findings showed that over 12,400 people skipped their prostate screening appointments, leading to a 45% higher risk of death from prostate cancer compared to those who did attend their screenings.

The findings were presented at the European Association of Urology Congress 2025, March 21–24, in Madrid, Spain.

Why men avoid prostate cancer screenings

Choosing not to take part in screening may stem from a complex combination of factors, according to the study’s lead author, Renée Leenen, MD, and PhD researcher in Professor Monique Roobol’s team at the Erasmus MC Cancer Institute.

“The European Randomized study of Screening for Prostate Cancer (ERSPC) was initiated in the early 1990s to assess the effect of prostate-specific antigen (PSA)-based screening on prostate cancer (PCa) mortality at a population level. In this secondary analysis, we aimed to get insight into the risk of dying of PCa in screening non-attenders using long-term data from the ERSPC,” Leenen told Medical News Today.

70% of the population needs to be screened, says WHO

“For any screening program to be effective, the World Health Organization (WHO) recommends that 70% of the population needs to be exposed to the screening test,” Leenen pointed out.

“Nevertheless, current cancer screening programs low and declining participation rates,” he noted.

Non-attendance may also be one of the biggest counteracting factors when it comes to successful screening for prostate cancer.

“We found that men who were offered screening but did not attend population-based screening are at higher risk of dying from PCa compared to men that were not offered screening. Consequently, non-attendance may be the biggest counteracting factor to the successful implementation of population-based screening programmes for (prostate) cancer.”

— Renée Leenen, MD

“Hence, there is an urgent need for further qualitative research to explore screening non-attenders and understand why, although being offered screening, they opted not to attend population-based screening,” Leenen explained.

“This could inform tailored intervention to address awareness, informed participation and inequalities in access,” Dr. Leened added.

Why prostate cancer screening rates were low

In 2012Trusted Source, the U.S. Preventive Services Task Force discouraged people from undergoing prostate-specific antigen (PSA)-based prostate cancer screening due to overteratment and overdiagnosis from the years before. However, later dataTrusted Source showed that lower screening rates were linked to an increase in advanced cancers.

Ramkishen Narayanan, MD, board certified urologist and urologic oncologist and Director of the Center for Urologic Health at The Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical Center in Burbank, CA, who was also not involved told MNT, said that “the European Randomized study of Screening for Prostate Cancer (ERSPC) has been a touchstone for the importance of prostate cancer screening in the U.S. for over 10 years now.”

“This updated study from our European colleagues continues to highlight the importance of prostate cancer screening in preventing prostate cancer-related deaths,” he said.

“The initial ERSPC study (Schröder et al., 2014) informed us that if you perform a PSA screening blood test in about 1,000 men, you will end up diagnosing and treating 37 men to prevent one prostate cancer-related death,” Narayanan explained.

“Taken at face value this may not appear very impressive and historically there was over-treatment of prostate cancer in the U.S., specifically men diagnosed with low risk prostate cancer getting surgery or radiation and ‘suffering in silence’ with expected treatment effects on urination and sexual function,” Narayan said.