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Prostate cancer cases skyrocket

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The lives of many men are unnecessarily being thrown into turmoil because of operations to remove prostate tumours later found to pose no threat to health.

Cancer Council NSW has found that there has been a 276 per cent increase in the number of newly diagnosed prostate cancer cases over the past 20 years. This compares with a 21 per cent increase in the total number of all cancers diagnosed over the same period.

The development has worried experts, who warn over-diagnosis could be ruining men’s lives by leading to invasive operations for harmless tumours.

A recent report by the Australian Institute of Health and Welfare (AIHW) found that prostate cancer is the most commonly diagnosed cancer in Australia, and is the fourth biggest killer of men. Early detection has improved the survival rate, with only 26 out of 100,000 men expected to succumb to the disease in 2020, compared with 34 in 1982.

Prostate cancer is diagnosed through a rectal examination and the use of a prostate-specific antigen (PSA) blood test. But concern have increasingly been raised over the appropriateness of the PSA test.

AIHW found more than 8500 PSA tests were given to men aged 34 year and younger last year, despite warnings from the Cancer Council and the Urological Society of Australia and New Zealand that tests for men in their 20s and 30s were inappropriate.

“At the moment we are working with imperfect tests,” Associate Professor Freddy Sitas from the Cancer Council NSW said. “The current tests often fail to distinguish between a low-risk prostate cancer and one that is life threatening.”

“The tests do and have saved men with aggressive forms of the disease, but at a high cost when measured against the number of likely over-diagnoses.

“The increased number of men diagnosed has led to many having highly invasive treatments resulting in unnecessary long-term complications.”

The Cancer Council also found that although there was a large increase in diagnoses of prostate cancer, there was only a 27 per cent decline in deaths from prostate cancer.

Associate Professor Sitas said this reflects the inaccuracy of the screening tests, and indicated that many men were diagnosed with cancers that would not have harmed them.

“Saving lives is our priority, but we urgently need a better test so that we can achieve better mortality outcomes without so many men being diagnosed with indolent cancers.”

Leading cancer organisations are developing improved guidelines for prostate cancer screening and management, and they are expected to be finalised in early 2015.

Kirsty Waterford