Should the UK lower the age for prostate cancer detection?

	Tweet

Prostate cancer screening occurs in many countries ahead of evidence from ongoing trials. In many countries, early detection (including the UK, when practised), and opportunistic screening commences at 50 years, but a lower age limit has recently been adopted in the USA based on two studies that found elevated prostate specific antigen (PSA) levels in men in their 40s was associated with subsequent prostate cancer.

So a team of UK researchers set out to investigate the feasibility of prostate cancer testing, disease prevalence and characteristics in a random group of younger men. Their findings are published on bmj.com today. 

The study involved 473 men aged 45-49 years randomly selected from eight general practices in one UK city.

Of 442 men (34%) who agreed to PSA testing, 54 (12%) had an elevated PSA result. These men were invited for further testing (an ultrasound-guided prostate biopsy, a repeat PSA test, and a digital rectal examination).

Ten prostate cancers were detected (a 2.3% detection rate, similar to that in older men). The five men whose tumours were potentially risky to health agreed to have one of three treatment options (radiotherapy, surgery, or active monitoring).

This study shows that men younger than 50 years will accept prostate cancer testing, but at a much lower rate than older men, say the authors, so if screening were introduced, greater efforts would be needed to maximize uptake in this age group.

If the UK male population aged 45-49 years (2,236,000) were to undergo PSA screening they estimate that 272,905 men would have a raised PSA and of these 51,449 would have prostate cancer.

Some of these cancers may benefit from treatment, they say, but this has to be set against the likely distress caused to the 221,456 men with negative biopsy results and the risks of over-treatment and associated side-effects to those diagnosed with cancer.

This study will inform the debate about PSA thresholds and age limits only if prostate cancer screening is proven to be effective in ongoing trials, they conclude.

Until the results from ongoing trials are available, policy should advocate informed discussion between clinicians and patients about the benefits, potential harms, and limitations of prostate cancer screening, says an accompanying editorial.

Contact: Emma Dickinson

44-020-738-36529
BMJ-British Medical Journal

RELATED STORIES:
New Finding Suggests Prostate Biopsy is Not Always Necessary   No Evidence That Widely Prescribed Statins Protect Against Prostate Cancer   Discovery of a new virus in prostate tumors   Mediterranean Diet May Help Prevent Prostate Cancer   Daily drinking may raise risk of several cancers   Drug shows promise in prostate cancer spread to bone   Fat intake increases prostate cancer risk   Prostate cancer spurs new nerves   Coffee may reduce risk of lethal prostate cancer in men   Diet and medications may assist prevention of prostate cancer   PSA test alone not an ideal predictor of prostate cancer   Selenium-Protein Deficiency Raises Prostate Cancer Risk   Laser may reduce prostate surgery’s sexual side effects   Fit Friday: Reducing prostate cancer death risk, diet’s role in asthma, workout clothes   Many men struggle to work after prostate cancer   Prostate cancer patients see high survival rates with seed implants   Folic Acid Supplements Linked To Higher Risk Of Prostate Cancer   Prostate Cancer Surgeons “Feel” With Their Eyes   New Targeted Therapy Effective in Treating Advanced Prostate Cancer   Young men with prostate cancer benefit from radiation therapy   Aspirin, Other NSAIDs, May Prevent or Delay Enlarged Prostate   CCNY researchers demonstrate effectiveness of contrast agent Cytate in detectcing prostate cancer

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]