Why screening for prostate cancer could do more harm than good
Cancer screening is something I am really passionate about.
Living in a country with among the highest skin cancer rates in the world my husband and I are booked in for ongoing annual skin cancer checks.
I am also a huge proponent of bowel cancer screening. At a recent Gut Foundation fundraiser I learnt about a Tom, a 28 year old, fit young man, who as a result of positive result with an at-home bowel cancer screening kit (also known as FOBT kit) went on to have a colonoscopy which found 100 pre-cancerous polyps. That is 100 growths in this fit, healthy, marathon running young man which would have most likely grown into bowel cancer. Screening has saved his life.
I never miss a pap smear and I always check with the females in my family to ensure they are having regular mammograms.
However, when it comes to prostate cancer screening, I am not so convinced.
You see, when it comes to prostate cancer screening through PSA testing, the scientific jury is out. It seems, based on current research that the screening could in fact be doing more harm than good.
You see, prostate cancer grows very slowly. So a man can live with it for years and ultimately die of something unrelated. However, if he is found to have the cancer the natural reaction is to receive treatment. This treatment, usually involving surgery, can result in long term urinary incontinence and erectile dysfunction (in reportedly, about 20-30% of men). I know what many of you are probably thinking. I would prefer to have incontinence and erectile dysfunction than cancer. But, if new scientific findings are correct, the cancer may in fact be harmless. And on top of that, the PSA test has a very large chance of falsely diagnosing you with cancer when in fact there is nothing wrong.
An article published this week in Forbes reported on a large scale U.S study which, “looked at the effect of annual PSA screening on more than 75,000 men, and found no benefit at all.”
In addition the article reported that, “A separate large study in Europe showed a very small benefit, but only in 2 of the 7 countries participating in the study. Suppose your doctor also explained that if you have a positive PSA test, there’s an 80% chance that it will be false – that you won’t have cancer.”
As a result of such research the U.S. Preventative Services Taskforce has recommended that men not be screened for prostate cancer.
However, naturally this has been met with protest by North American urologists who are outraged. After all, for decades they have been advocating the screening for their patients.
I recommend anyone considering prostate cancer screening reads the Forbes article and discusses the screening risks and benefits in detail with their family doctor. It is a very personal decision and each individual case should be assessed individually. But arming yourself with as much knowledge as possible is a great step to ensuring you are heading in the right direction.
This article was referred to me through twitter by @picardonhealth.
