MEN are being over-diagnosed with prostate cancer, leading to an increase in invasive operations for harmless tumours that in some cases are being blamed for suicides.
A 276 per cent increase in prostate cancer diagnoses over the last 20 years has experts worried over diagnosis could be ruining men’s lives.
Even though the government, the Cancer Council and expert international bodies advise against prostate cancer screening around 60 per cent of men aged over 50 and many under that age are being screened every year on the advice of their GP.
“At the moment we are working with imperfect tests. The current tests often fail to distinguish between a low-risk prostate cancer from one that is life threatening,” Associate Professor Freddy Sitas, lead researcher from Cancer Council NSW says.
“The increased number of men diagnosed has led to many having highly invasive treatments resulting in unnecessary long-term health complications.”
Cancer Council NSW research published today in Cancer Epidemiology found a 276 per cent increase in prostate cancer diagnoses in the last 20 years compared to a 21 per cent increase in all cancer diagnoses.
Although there was a threefold increase in diagnoses there was only a 27 per cent decline in deaths from prostate cancer.
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While he concedes the tests do save lives in men with aggressive forms of the disease, Professor Sitas says it comes at a high cost when measured against the number of over diagnoses.
Researchers in the United States found around 40 per cent of men diagnosed with prostate cancer are unlikely to have their life expectancy shortened by the cancer, Professor Sitas says.
The Australian Government, the Cancer Council and leading international health bodies do not support population based PSA screening for this reason.
The Cancer Council’s National Cancer Prevention Policy says treatment for prostate cancer often causes “significant side effects such as urinary incontinence and impotence, without any compensating benefit”.
Researcher David Smith has told News Corp Australia his research into what kills men diagnosed with prostate cancer has uncovered a high risk of suicide within the first six months of a prostate cancer diagnosis.
“The suspicion we have is that a number of men have underlying depression and anxiety and a diagnosis of prostate cancer is enough to tip them over to suicide,” he said.
Professor Sitas says around 60 per cent of men aged over 50 have had a PSA test, a similar rate to the number of women who are tested for breast cancer where there is an official screening program.
A Prostate Cancer Foundation of Australia survey of over 1,200 men earlier this year found despite advice against screening there was a “de facto” screening program in practice.
Eight per cent of men aged between 18 and 39, 25% of men aged 40 to
44 and 37% of men aged 45 to 50 had been tested for prostate cancer, most at the urging of their GP, the foundation found.
“Despite public health and primary care advice to the contrary, Australia has an unorganised de facto screening program for prostate cancer being delivered in General Practice, with men starting to be tested from their twenties onwards,” the foundation said.
Leading cancer organisations are working on improved guidelines for prostate cancer screening and management to be finalised in early 2015.
Professor Sitas says Cancer Council NSW has blood samples from around 2,000 men half with prostate cancer and half without that can be used to quickly check if any new prostate cancer test is effective.