Debate over controversial prostate cancer test put to rest

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By medical reporter Sophie Scott

Debate over the controversial prostate cancer blood test is set to be put to rest after Australian health experts reached agreement over testing.

Cancer agencies and health professionals have come together to write new guidelines that indicate who should get tested and when.

The Prostate Specific Antigen (PSA) has been the subject of debate since it was developed because it can lead to false positives and unnecessary treatment.

Patient groups frequently advocated broad-base screening, but health professionals have been concerned it leads to unnecessary invasive procedures.

The new treatment guidelines have been unveiled at the World Cancer Congress in Melbourne.

Each year about one in five Australian men aged between 45 and 74 have a PSA test.

There are a number of new guidelines. For example, in healthy men without symptoms:

  • PSA testing should be done every two years between ages 50 and 69 and only in men who want testing and are informed of risks and benefits
  • Digital rectal exams are not recommended for routine testing for men with no symptoms visiting their GP
  • Do not offer PSA testing to men unlikely to live another seven years
  • Evidence-based information for men deciding whether to have PSA test

The guidelines were put together by an expert advisory panel which included GPs, public health experts, urologists, pathologists and allied health professionals.

Panel chair Professor Villis Marshall said the lack of consensus on PSA testing confused men and their health advisers.

“We simply cannot afford to ignore this important health issue,” he said.

The guidelines were put together after a joint project between the Cancer Council and Prostate Cancer Foundation Australia.

Cancer Council Australia chief executive Professor Ian Olver said the PSA test was not accurate enough for population screening but remained in widespread use.

“So it’s important to assist patients and practitioners with guidelines that could help maximise the benefits of the test and minimise the harms,” he said.

About 22,000 Australian men are diagnosed with prostate cancer each year and 120,000 Australian men live with the disease.

The draft recommendations are now open for public comment.