Calls to screen men in their 40s for prostate cancer

Swedish researchers argue that men aged in their mid-to-late 40s should be offered a screening test for prostate cancer as this could detect almost half of potentially deadly cases of the disease, providing them with a chance to have necessary treatment before the cancer can develop.

However, the effectiveness of the screening process in question – prostate specific antigen (PSA) testing – has been widely open to debate for several years as the test cannot determine between slow-growing and fast-growing cancer, can cause needless worry and medical tests with a false positive result and has been known to occasionally miss the cancer and provide a false sense of reassurance.

The test can be done at your own GP surgery and involves measuring the level of the protein PSA in your blood. PSA is produced by the prostate gland. Some of the PSA manages to travel into the blood, with levels varying depending on prostate health and age. Currently there are no NHS routine screening programmes for prostate cancer in the UK but Men over the age of 50 are able to have a free PSA test on the NHS if they choose.

The results of which are published in the British Medical Journal, Professor Hans Lilia and colleagues from Lund University in Sweden, working together with researchers from the Memorial Sloan-Kettering Cancer Center in the U.S., found that if this screening was offered to men aged between 45 and 49, it could potentially spot prostate cancer in almost half of cases.

Their claim emanated from a thorough analysis of a study that was conducted between 1974 and 1984, comprising of 21,277 Swedish men aged between 27 and 52. At the beginning of the study period, every man had donated a blood sample and researchers went back to these samples to conduct PSA tests.

The PSA readings were compared against which men went on to develop prostate cancer, who survived and of what age each death occurred. It was calculated 1,369 of the men had prostate cancer; 241 being at an advanced stage and 162 men died.

With these figures being considered in great detail, they came to the conclusion screening under the age of 45 found very few cancers, screening after the age of 50 generally would be too late an age, whereas 44% of the deadlier cancers were detected through screening that was carried out between the ages of 45 and 49.

In their report, the researchers state: “At least half of all men can be identified as being at low risk and probably need no more than three PSA tests in a lifetime. This is likely to reduce the risk of over-diagnosis while still enabling early cancer detection among those most likely to gain from early diagnosis.”

Dr Anne Mackie, director of NHS screening programmes at Public Health England, says the organisation is considering the findings of the study, adding: “We are currently in the process of a scheduled review for a screening programme for prostate cancer and will make a recommendation towards the end of 2013.”