ELEANOR HALL: A study from the Cancer Council in NSW has revealed a massive jump in the number of men being diagnosed with prostate cancer.
Researchers found a 250 per cent increase in the number of men testing positive for the condition over the last two decades.
The scientists say this is mainly because more men are taking the cancer test, but they say there hasn’t been an equal rise in the number of lives saved and some medical experts say there may be too much testing.
As Will Ockenden reports.
WILL OCKENDEN: The test for prostate cancer looks for the existence of a protein in the patient’s blood. If it’s found, it can indicate a cancer is present.
But it can also indicate other problems with the prostate, like a small infection.
Because the PSA test basically returns a simple yes or no, it can lead to further invasive testing through biopsies when a patient was never at risk.
Professor Freddy Sitas is with the Cancer Council.
FREDDY SITAS: The current test failed to distinguish between low risk prostate cancer and from one that is life threatening.
WILL OCKENDEN: The study from the Cancer Council on detection rates of prostate cancer found they increased by nearly 280 per cent over the last two decades.
Over the same period, the diagnosis for other common cancers only rose by 21 per cent and despite the rise in testing, survival rates have only increased by a third.
Researchers say that indicates something could be wrong.
FREDDY SITAS: Men are becoming more health aware and this is something that you know, people feel that they need to proactively do. I guess what is missing is a good conversation with the general practitioner and to find general practitioners who are up to speed with the most recent literature, on what the after-effects of a test might be and the consequences of a positive test result.
WILL OCKENDEN: The imprecise nature of the PSA test also means that doctors are picking up and treating problems that would have been better left alone.
FREDDY SITAS: Survival is fantastic for prostate cancers, very good, over 90 per cent. So something is working. We are picking up, some people, with prostate cancer that are cured. However the downside is we are also picking up people whose prostate cancer would have been indolent and would have done nothing and so we are trying to find a better test.
WILL OCKENDEN: Cancer experts are working on new guidelines for prostate screening, and are expected to be finished by early 2015.
Others say it’s possible that too much testing is going on.
Professor Judith Clements is from the Australian Prostate Cancer Centre Queensland.
JUDITH CLEMENTS: I think what we’re trying to get away from is the suggestion that every man over the age of 60 in particular, maybe 55, should go for a yearly PSA test. We think that that’s not necessary.
Some men would start being tested around the age of 40. Usually that relates to men who have a family history and I think it’s correct that they should be looking at starting that kind of testing at that age.
WILL OCKENDEN: Is the best thing though to do, it seems, in many cases if there’s been such a jump in diagnosis of prostate cancer, nearly 280 per cent. Is the best thing to do just to stop early testing so people don’t realise that they’ve got it, so then you don’t have this problem when people are being inappropriately treated down the line?
JUDITH CLEMENTS: That’s a hard call, because if you do end up having prostate cancer and particularly an aggressive form, then you would want to have been treated for it and unfortunately there are no real clinical symptoms for prostate cancer until it is advanced and then often it’s too late to do anything that would lead to a longer life.
WILL OCKENDEN: So the choices are you get a positive test and then you have a choice whether or not you want to have treatment, or you don’t have the test and then you just can live on in ignorance?
JUDITH CLEMENTS: That’s precisely, I guess a choice. I think going down the ignorant line is not necessarily the right thing to do either.
ELEANOR HALL: That’s Professor Judith Clements, from the Australian Prostate Cancer Centre, ending Will Ockenden’s report.