SAN FRANCISCO—Offering PSA testing for free is associated with a reduction in prostate cancer mortality, according to an Austrian study.

The study, presented at the American Urological Association annual meeting, looked at the effect of free PSA screening on a population-wide basis with 20 years of follow-up. Researchers in Innsbruck evaluated data from the Tyrol Project. Started in 1988, the project featured free PSA testing for all men aged 45-75 years in Tyrol, an Austrian state. Approximately 120,000 men were screened.

In 2005, a cumulative testing rate of 86.6% was achieved and 8,054 transrectal ultrasound-guided biopsies were performed. In men with organ-confined lesions, surgical removal of the prostate was recommended. The researchers found that 86.3% of patients with T1 or T2 disease were treated with radical prostatectomy (RP), 8.7% were treated with brachytherapy, and 8.7% received external beam radiation. Between 1988 and 2008, a total of 2,153 RPs were performed. 

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Overall, since 1996, prostate cancer mortality rates decreased by 48% in 2003, 55% in 2004, 52% in 2005, 49% in 2006, 41% in 2007, and 64% in 2008.

Other Austrian states experienced declines in prostate cancer mortality, but these declines were not as dramatic as in Tyrol.

Researcher Jasmin Bektic, MD, of Innsbruck Medical University, who presented study findings, emphasized that “if you are going to do [free PSA screening] it is necessary that you have the ability to give patients the optimal treatment.”