18 October 2021
Leading urologists around the country fear outdated guidelines for prostate cancer screening are putting lives at risk, with a spike in the number of men being diagnosed with high or very-high risk disease.
New data released by the AIHW also reveals a 10 percent increase in the number of men dying from the disease between 2016, when the guidelines were launched, and 2019 (the latest data available).1
PCFA CEO, Professor Jeff Dunn AO, said the current guidelines need to be scrapped.
“Australia’s existing guidelines are five years old and are based on outdated data,” he said.
“The screening recommendations are no longer current, and they need to be reviewed in order to reduce avoidable deaths, taking into consideration the latest evidence.
“Of particular concern, some GPs refuse to offer PSA testing to their patients, and as a result some men are being diagnosed when the cancer has already spread. When that happens, it’s harder to save their lives.
“The cold fact is that under the current guidelines, many men are being given incorrect advice about their prostate cancer risks and screening options.
“We need to provide clearer guidance for men and GPs, supported by a public awareness campaign. This is particularly important given that prostate cancer often has no symptoms, and increasing numbers of men go untested, only to be diagnosed with late-stage and incurable disease.”
The PSA test is a simple blood test that measures men’s levels of prostate-specific antigen, which can be an indicator of prostate cancer.
“Current guidelines suggest men talk to their doctor about screening every two years from the age of 50, or earlier if the man has a family history, and recommend against testing after the age of 70.
“We need to review these recommendations and consider whether the two-year interval period should be shortened, and we also need to review the recommendation not to test men after the age of 70.
“Life-expectancy for men over the age of 70 has increased, which means we need to re-examine the risks and benefits of testing. The latest evidence shows that we are seeing significantly higher rates of late diagnosis and death among men in this age bracket, which is completely unacceptable and needs to change.
“The current guidelines also lack recommendations on the use of MRIs in detecting prostate cancer more accurately, which is a major oversight.”
The call for a review has been backed by leading urologists including Dr Peter Heathcote and Professor Mark Frydenberg.
The latest report by the Prostate Cancer Outcomes Registry (PCOR) for Australian and New Zealand shows that in 2018 (the latest data available) 38 percent of men were diagnosed with high to very high-risk prostate cancers - a jump from 34 percent in just one year.
The report also found 32 per cent of men diagnosed with prostate cancer had a PSA level of 10 or above at point of diagnosis - more than three times the recommended level to get the test in the first place.
“Men are being diagnosed with prostate cancer later, which means they are less likely to survive their diagnosis,” Prof Dunn said.
“It also means they’ll need to undergo more aggressive treatment, with long-term impacts on their overall health and quality of life.”
Around 75% of Australians don’t know the current testing guidelines.
“We’ve done a great job of raising awareness of breast cancer in Australia, but we continue to lag behind in prostate cancer. A clear set of Consumer Guidelines is what we urgently need,” said Prof Dunn.
“Prostate cancer is the most common male cancer in Australia. One man is diagnosed every thirty minutes and nine men - our fathers and sons - will die every day.
“Once prostate cancer has spread to the bone, it’s very hard to stop. It’s critical that we review the guidelines to ensure all Australian men get a fair go at detecting it early.”
Leading urologist, Dr Peter Heathcote, backed the call.
“It’s important for patients and general practitioners to be aware that medical opinion has moved on significantly when it comes to screening and diagnosis of prostate cancer.
“The two large European screening trials continue to show increasing benefits of PSA screening over time, and clearly demonstrate PSA screening is saving lives.
“With the latest medical imaging techniques and improved active surveillance protocols, we now have fewer men having unnecessary biopsies, or being over-diagnosed or unnecessarily treated for low-risk cancers,” Dr Heathcote said.
To find out more about your risks and screening options, call PCFA’s Specialist Telenursing Service on 1800 22 00 99 or go to www.pcfa.org.au.
Media contact: Laura McKoy | M. 0435 094 788
1 Comparison of 2016 actual mortalities (3254) with latest mortality figures available from 2019 (3582): Cancer data in Australia, Cancer summary data visualisation