Lowering the age of baseline testing for prostate cancer
September 4, 2013. Today we released new recommendations to empower Canadian males to take a more active role in monitoring their number one cancer risk: prostate cancer. A recent nationwide poll showed that while 87% of Canadian men aged 35+ fear prostate cancer, less than half anticipate being tested in the next 12 months - even though early diagnosis can increase the odds of survival.
"Prostate Cancer Canada recognizes that men need to be better informed about prostate testing, particularly the Prostate Specific Antigen (PSA) blood test," says Dr. Stuart Edmonds, VP, Research, Health Promotion & Survivorship, Prostate Cancer Canada. "To address this confusion, we conducted an extensive review of the evidence and from this developed our primary recommendation: Men should get a baseline PSA test in their 40s instead of waiting until their 50s."
"PSA levels can vary between individuals so a test in the early 40's can provide a baseline and allow us to better tailor clinical follow-up," says Prostate Cancer Canada spokesperson Dr. Rajiv Singal, Urologist at Toronto East General Hospital and Assistant Professor at the University of Toronto. "The PSA is an important marker for a disease in which symptoms are not always present."
PCC also recommends the decision to end PSA testing should be based on individual risk, rather than an arbitrary cut-off such as age 70. "Men are living longer and their lives should not be cut short or diminished by prostate cancer," says Dr. Edmonds. "The decision to end testing should be a shared decision determined by a man and his primary care provider."
"Some men are at increased risk because of ethnicity (Black African or Black Caribbean descent), a family history of prostate cancer, or age," says Dr. Singal. "Men at high risk should talk to their primary care provider even earlier than their 40s. However, in my 18 years of practice, the majority of aggressive cancers have been found in men with seemingly no risk factors - underscoring the importance of baseline testing."
Prostate Cancer Canada's recommendations will help to relieve confusion, uncertainty and fear among Canadian men. An online poll conducted for Prostate Cancer Canada among men aged 18+ found over half (55%) either didn't know or under-estimated a man's lifetime risk of developing prostate cancer.
Only 16% of respondents were able to correctly identify that a man's lifetime risk of prostate cancer is 1 in 7.
Almost half (44%) of men admitted being reluctant to be tested for prostate cancer. Also concerning to Prostate Cancer Canada is that three-quarters of men (74%) assumed that a positive test result inevitably leads to treatment. PSA testing is primarily a means of monitoring prostate health. One abnormal test result does not mean leaping into treatment.
"We released our recommendations because we believe it is critical for men to initiate these important discussions with their healthcare providers," says Rocco Rossi, CEO of Prostate Cancer Canada. "Untreated and late-stage prostate cancer can have devastating physical and psychosocial effects and men need to become informed healthcare consumers and their own healthcare advocates."
"Given the monitoring and treatment options available, it is inexcusable that prostate cancer should be missed or ignored," adds Dr. Singal. "We fully appreciate that men may be fearful of the process - but without a quick check, we can't know what are dealing with. It is critical to their health and well-being that Canadian men be aware, talk to their doctors and get tested."
Cause of Prostate Cancer
Statistics in 2010
Early Detection Saves Lives
PSA cut-off levels adjusted for age and race.
|Above these levels you need further testing|
|40-49||2.5 ng/ml||2.0 ng/ml||2.0 ng/ml|
|50-59||3.5 ng/ml||4.0 ng/ml||3.0 ng/ml|
|60-69||4.5 ng/ml||4.5 ng/ml||4.0 ng/ml|
|70-80||6.5 ng/ml||5.5 ng/ml||5.0 ng/ml|
Adapted from Klotz L.H. Prostate Cancer: A guide for patients. Prospero Books, 2000
For additional information please contact:
Prostate Cancer Support Thunder Bay
Call 1-807-627-0333 OR attend our Monthly Meeting
3rd Thursday of every month, 7:00pm at the 55 Plus Centre, 700 River Street
Disclaimer. The Prostate Cancer Support Thunder Bay does not assume responsibility or liability for the contents or opinions expressed herein. Although every precaution is taken to ensure that information is accurate, differences of opinion exist and the Prostate Cancer Support Thunder Bay takes no responsibility for views expressed herein, nor do they necessarily reflect those of the publishers, sponsors, or organizations affiliated with us. The Prostate Cancer Support Thunder Bay does not recommend treatment modalities, medications, or physicians. Information should not be used for purposes of self diagnosis or as an alternative to medical care. If you suspect you have cancer see a physician immediately.