Should the UK lower the age for prostate cancer detection?

Nov 16, 2007

Should the UK lower the age for prostate cancer detection in line with the USA?

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.

Source: British Medical Journal

Explore further: Medical marijuana helpful for cancer-linked symptoms

add to favorites email to friend print save as pdf

Related Stories

Underfire Uber ramps up rider safety

5 hours ago

Uber is ramping up driver background checks and other security measures worldwide after the smartphone-focused car-sharing service was banned in New Delhi following the alleged rape of a passenger.

US probe links NKorea to Sony hacking

6 hours ago

A U.S. official says federal investigators have now connected the Sony Pictures Entertainment Inc. hacking to North Korea and are expected to make an announcement in the near future.

New York state bans fracking

6 hours ago

Governor Andrew Cuomo said Wednesday he would ban hydraulic fracking in New York State, citing health concerns about the controversial oil and gas drilling technique.

Sony cancels NKorea parody film release after threats

6 hours ago

Hollywood studio Sony Pictures on Wednesday abruptly canceled the December 25 release date of "The Interview," a parody film which has angered North Korea and triggered chilling threats from hackers.

Recommended for you

Medical marijuana helpful for cancer-linked symptoms

8 hours ago

(HealthDay)—Cannabis and cannabinoid pharmaceuticals can be helpful for nausea and vomiting, pain, and weight loss associated with cancer, according to research published online Dec. 10 in CA: A Cancer Jo ...

Mutations need help from aging tissue to cause leukemia

12 hours ago

Why are older people at higher risk for developing cancer? Prevailing opinion holds that, over time, your body's cells accumulate DNA damage and that eventually this damage catches up with the body in a way ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.