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World body addresses prostate cancer test problems

New international guidelines released yesterday aim to address problems around prostate cancer screening.

One in eight white men are likely to be diagnosed with prostate cancer in their lifetimes

One in eight white men are likely to be diagnosed with prostate cancer in their lifetimes

Prostate cancer affects the prostate gland in the male reproductive organs and is one of the most common cancers in men.

One in every 26 South African men will develop prostate cancer, with white men having a drastically increased risk. Around one in eight white men are likely to develop the cancer in their lifetimes.

The primary test for prostate cancer, the Prostate Specific Antigen (PSA) test, is controversial as it sometimes has false positives and picks up slow-developing cancers, often leading to unnecessary treatment with adverse side effects such as impotence and incontinence.

“The current PSA test is not accurate enough for population screening, yet it remains in widespread use. We need to focus on helping both patients and health care professionals understand the risks and benefits for this test to empower them to make more informed choices around screening,” said Professor Mary Gospodarowicz, president of the Union of International Cancer Control (UICC) at the release of the draft guidelines at the World Cancer Congress currently underway in Melbourne Australia.

A proportion of prostate cancers detected as a result of PSA tests would never have bothered men had they not been tested. Such cancers are commonly referred to as over-diagnosed cancers, according to the draft clinical guidelines.

“High-risk individuals, with a close family member that has been diagnosed with the cancer, are advised to start screening at age 45”

“The draft guidelines are intended to inform the interactions between men and their doctors, when a man might request a PSA test or his doctor might offer one,” said Emeritus Professor Bruce Armstrong from the University of Sydney, noting that the guidelines did not recommend national screening programmes.

All asymptomatic men considering having a PSA should be informed of the potential benefits and risks of the test, and men who are unlikely to live another seven years should not be offered the test.

Men between the ages of 50 and 69 years old with no symptoms of prostate cancer who want to undergo testing can take the PSA test once every two years. High-risk individuals, with a close family member that has been diagnosed with the cancer, are advised to start screening at age 45.

Men with diagnosed early-stage prostate cancer should be offered active surveillance but no treatment for the disease. Men with potentially curable prostate cancer considering active surveillance should be advised to undergo immediate treatment.

The draft guidelines were released yesterday for public consultation and are expected to be finalised in early 2015. – Health-e News.

An edited version of this story was originally published in the 8 December edition of the Cape Times newspaper.

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