RECENTLY I posed a question to Professor Ian Olver, chief executive of Cancer Council Australia.
The question surrounded confusion on the use of population screening of the diagnosis tool PSA test for prostrate cancer and possible unnecessary surgery when the cancer is still growing.
Prostate cancer is the most commonly diagnosed cancer in Australian men (apart from non-melanoma skin cancers) and is the second-leading cause of cancer death in Australian men.
Increasing age is the most significant risk factor for prostate cancer. It is rare in men under 45 years of age. A family history of prostate cancer is also a risk factor for the disease, although less significant than age.
There is some evidence that environmental and lifestyle factors may also increase the risk of prostate cancer. But more research is required before any conclusions can be drawn.
Cancer Council Australia’s position is that the benefits of population screening for prostate cancer are unproven.
The central concern is that many prostate cancers will not progress sufficiently to cause harm in the man’s lifetime, while others will progress and be lethal. No present test (including the PSA test) adequately differentiates between these types of cancer.
In the absence of evidence showing a clear benefit of population-based screening for prostate cancer, a patient-centred approach for individual decisions about testing is recommended.
Ideally this will be an informed, shared, decision-making process between the doctor and man patient.
Screening discussions and decisions should always include and take into account age and other individual risk factors such as a family history of the disease.
Research into prostate cancer diagnosis and treatment must continue to be a high priority, in particular, the development of an accurate test to detect the potentially lethal form of prostate cancer.