The two types of test at issue are a blood test (a prostate-specific antigen or PSA test) and a manual examination (a digital rectal examination or DRE).  According to Andrew Giles, CEO of the Prostate Cancer Foundation of Australia, there is unfortunately confusion in the community about the benefits of these tests and the position of various stakeholders about their appropriate use.

“Based on the latest research, we currently recommend that men at 50 with no family history of prostate cancer, and men at 40 with a family history, should talk to their doctor about voluntary annual assessments in the form of a Prostate Specific Antigen (PSA) blood test together with a Digital Rectal Examination (DRE),” said Mr Giles. “There is evidence that this approach will save lives in the future and we are keen to clarify these recommendations for Australian men.”

Mr Giles emphasised that the latest international, randomised population based research continued to suggest that testing could save lives.  “A recent study from Sweden published this year in the Lancet1 which included 20,000 men showed that death from prostate cancer was reduced almost by half over 14 years in the group that were encouraged to take PSA tests. Every 12 men diagnosed translated into the saving of one death from prostate cancer. This positive evidence is substantial and growing.

“These tests are useful indicators of elevated risk and men are entitled to make informed decisions about the relevance of these tests for them on an individual basis. We are not talking about national, compulsory, publicly funded screening programs at a particular age. We are talking about individual Australian men making decisions – at an appropriate time and in consultation with their doctor – about whether it is time for them to have a test which helps indicate their risk of prostate cancer,” said Giles.

“If the tests show elevated risk then they can be guided by their doctor about whether a biopsy might shed further light on the issue,” said Giles. “For most the test will be negative.  But we know of many men who have made the personal decision to undergo PSA tests and for those tests to lead to the eventual discovery of an aggressive cancer in the prostate. Many of those Australian men are still enjoying life with their loved ones following successful treatment – a scenario which would have been almost impossible without the original decision to have a PSA.

“We are advocating informed voluntary risk assessment on an individual basis in the form of a test which provides an indication of risk – not widespread compulsory screening.

“Clearly the PSA test is not a cancer specific marker. It simply acts as an alarm to indicate there is a problem. That’s why a biopsy is required to determine a diagnosis of cancer. At this stage the PSA test is a viable and very useful alarm. A major focus of PCFA-funded research is the development of a more specific test to distinguish between indolent and aggressive cancers. In the mean time, Australian men should be encouraged to seek tests that help define their individual risk of prostate cancer”

For more information regarding this media statement or for interviews with Andrew Giles, please contact Martin Palin (0418 419 258) or Karina Candia (0402 307 056) at Palin Communications on 02 9412 2255. More about PCFA at www.prostate.org.au

Reference
ยน Mortality results from the Goteborg randomised population-based prostate-cancer screening trial. Hugosson et al. Lancet Oncol; 2010 June 30  2010.