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Otago Professor Doubts Merits Of Prostate Cancer Tests

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Fuseworks Media
Fuseworks Media

Wellington, Sept 24 NZPA - An Otago University professor has criticised a statement by an Australasian medical body on prostate cancer testing.

Associate Professor Brian Cox today called the stand on prostate-cancer specific antigen (PSA) testing by the Urological Society of Australia and New Zealand (Usanz) "poor public health medical practice".

It was also inappropriate, given available evidence, said Prof Cox, who works at Otago's Hugh Adam Cancer Epidemiology Unit.

Given current evidence and the failure of the Usanz to consider the results of a Swedish trial, its advocacy of PSA testing in asymptomatic men aged 55-69 seemed premature, at best, he said.

"Given the current conflicting evidence of any benefit from PSA testing in asymptomatic men and the known harms that can occur, I also cannot support the society's advocacy for a baseline PSA test."

NZPA yesterday reported the Usanz recommending men now have the first prostate cancer test at 40. It was 50 previously.

Cutting the age to 40 was based on evidence that the earlier diagnosis of prostate cancer would reduce the risk of death from the disease, Usanz said.

Prof Cox said three reports of randomised studies of screening for prostate cancer had been published this year.

Only one of the three suggested any possible reduction in mortality from prostate cancer from PSA screening -- and this included digital rectal examination and transrectal ultrasounds in many men.

"Two of the three studies found prostate cancer mortality to be slightly higher (10 percent and 13 percent) in men offered a PSA test, compared with those who were not.

A Reuters report carried by NZPA late last month said routine screening for prostate cancer had resulted in more than one million US men being diagnosed with tumours who might otherwise have suffered no ill effects from them.

The report, quoting US researchers, said prostate cancer screening was a double-edged sword, catching serious cancers in a few but causing needless worry and expense for the majority of men, who might be getting treatment for tumours growing too slowly to do any harm.

About 600 New Zealand men die of prostate cancer each year, according to the Cancer Society.

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