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Screening men born with a high risk of developing prostate cancer at the age of 45 would make financial sense, according to cancer charity Prostate Cancer Research. However, the organisation conceded more accurate tests would be needed to justify screening all men. Unlike breast, bowel and cervical cancer, there is no prostate cancer screening programme in the UK, with the onus on men to request a blood test from their GP once they are over 50. Despite more men dying from prostate than breast cancer, there currently is no accurate test for the disease.
The case for and against screening revolves around an imperfect test and finding some men’s aggressive cancers earlier. However, diagnosing and treating slow-growing tumours that pose no cancer risks would have an impact on a man’s health and lifespan. Magnetic resonance imaging (MRI) scans and tissue biopsies can help narrow down which men have cancer and need treatment. However, some men still end up being treated for non-aggressive prostate cancer.
Clinical trials have given mixed results about prostate screening. One, in Europe, shows it saves lives, but another, in the UK, suggests a more marginal benefit and a US-based study indicates that it does not save lives. The results cause difficulty in weighing up the risks and benefits, with one urological surgeon opining that black men, who have double the risk of prostate cancer, should consider having a PSA test at 40, particularly if they have a strong family history of the disease.
Prostate Cancer Research’s report stresses screening 45-69-year-olds at high risk – black men and those with a family history of the disease or particular gene mutations – would deliver an economic benefit after factoring in the treatment and impact on working lives and carers. However, researchers need more accurate tests to justify screening all men
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