PSA Testing and Concensus

NEJM just released a poll regarding the continuing use of PSA tests. They state:

We received 958 votes from readers in 67 countries. A little over half (55%) of all voters recommended PSA screening for the man in our clinical vignette — a split that revealed the lack of clinical consensus surrounding this important issue. North American voters preferred to screen with PSA testing: 59% of 489 voters from the United States and 67% of 46 Canadians voted in favor of PSA screening. European voters were less enthusiastic, with only 47% of 217 voters in favor of PSA screening.

 They continued:

A large number of respondents remarked that they recommended PSA screening on the basis of personal experience with elevated PSA levels that led to life saving treatment. Other respondents believed that data from the European Randomized Study of Screening for Prostate Cancer provide compelling evidence that PSA screening saves lives. Finally, a number of comments touched on patients' fears with regard to cancer diagnosis, and some clinicians were of the opinion that measuring the PSA level can reassure a patient that his physician is actively performing surveillance.

But as we had noted before the European Trial did PSA tests with 4 year intervals. As we have argued before the 4 year interval is the equivalent of not even testing. Thus it can be argued that the European tests are invalid in terms of their conclusions.