Prostate Cancer Screening – Which Way Forward?

With rising cases of prostate cancer in men, it has become vital to educate the public about the dangers of the disease and how to prevent it. The best advice is to go for screening early as this ensures the diseases is detected and stopped on its tracks before it spreads. Considering the condition mainly affects older men aged above 40 years, the general consensus is the test isn’t necessary for men aged below 40 years as it was to those aged 45 and above.

Screening for prostate cancer has always been a dilemma for physicians and this isn’t about to get any better. Statistics show that the cancer is becoming common in men aged less than 40 years; however, research shows that screening younger men is of no use and doesn’t have any true benefit. The dilemma deepens as some studies suggest that there is no real evidence that the popular prostate-specific antigen (PSA) exam adds any value.

Screening for prostate canceAccording to a report from European Association of Urology, some researchers are of the opinion that Prostate Specific Antigen (PSA) screening on men below 55 years is of no value. This isn’t the first time PSA has come under scrutiny though it remains a popular technique. In a 20-year study carried out from 1993 and involving 6822 patients aged between 55 and 59(continued until they attained the age of 75), preliminary screening showed that 189 men had cancer of the prostate. Towards the end of the experiment, 40 died of prostate cancer while 19 developed metastases.

The big concern is that out of the total 6822 only 40 men had benefitted from the test ( approximately 0.6%) yet they were being exposed to other dangers that come with cancer screening. Studies show that PSA screening can lead to over diagnosis with an estimated 5 out of 100 men put under unnecessary treatment. This means victims start treatment even though they are not at any risk but are exposed to side effects such as impotence, incontinence, and more.

The other side of the divide believes that PSA screening has saved many lives and there is no sufficient evidence to show that it adds little value. There are many grey areas when it comes to benefits and harm from mass prostate cancer screening. Critiques suggest that this screening which is marketed for the masses just like mammography should instead be left for the individual to decide. Caregivers face a real dilemma on whether to use it, when to use it, or if to adopt other alternatives such as digital rectal exam (DRE).