Getty ImagesScreening men born with a high risk of developing prostate cancer, once they reach the age of 45, makes financial sense, a cancer charity says.But Prostate Cancer Research also acknowledges more accurate tests would be needed to justify screening all men.There is no prostate-cancer screening programme in the UK, unlike those for breast, bowel and cervical cancer.Instead, the onus is on men to request a blood test from their GP once they are over 50.More men dyingThe debate around prostate screening revolves around an imperfect test and the trade-off between finding some men’s aggressive cancers earlier and the harms of diagnosing and treating slow-growing tumours that would never have affected a man’s health or lifespan.The case for and against is constantly reviewed in the UK, with the most recent report from the National Screening Committee, in 2020, saying the harms were too great. Further updates are expected this year.Despite more men dying from prostate cancer than women from breast cancer, there is no reliable test for the disease.The blood test men over 50 can request from their GP measures prostate-specific antigen (PSA), released by the prostate, a small gland located below the bladder involved in the production of semen.But PSA levels can be high for a variety of reasons – including an enlarged prostate, inflammation or infection, recent vigorous exercise or sex – or remain normal despite cancer.And there are many different kinds of prostate cancer – not all deadly.”There are prostate cancers that are so slow-growing that they will not affect a man’s lifespan,” GP Dr Margaret McCartney says. These are found in one in three men over 50.”And then you have a small number of very aggressive prostate cancers which do move quickly and cause harm,” Dr McCartney says.Follow-up magnetic resonance imaging (MRI) scans and a tissue biopsy can help narrow down which men have cancer and need treatment – but some still end up being treated for something that would never cause a problem.”Far more men have tests done to try to work out what kind of prostate cancer it is, than are going to benefit from it – there’s the problem,” Dr McCartney says.Conflicting resultsClinical trials have produced conflicting results about screening. One, in Europe, says it saves lives.Another, in the UK, shows a more marginal benefit.And a third, in the US, says it does not.Prof Hashim Ahmed, chair of urology at Imperial College London, says: “We need to screen 570 men to prevent one death – that’s a lot of men to counsel.” …
