If you are 55 and healthy, don’t take the prostate cancer test — scientists

Men who undergo PSA screening could potentially increase their risk of harm. PHOTO | FILE  

By JEFF OTIENO

In Summary

• Research has shown that the most common test done to ascertain whether a man has prostate cancer or not can be harmful rather than beneficial.
• High risk individuals are men with a family history of prostate cancer, those diagnosed with urinary tract infections and those experiencing sexual dysfunction, weight loss or suffering bone pain.

Men aged above 40 are often advised to take a prostate cancer test. But if you are below 55 and in good health, you may want to think twice about taking that test.

Research has shown that the most common test done to ascertain whether a man has prostate cancer or not can be harmful rather than beneficial.

The test, referred to as prostate-specific antigen (PSA) test, which measures the protein in the blood, has a high chance of producing a false positive result or “over-diagnosis,” according to a study done by the Canadian Task Force on Preventive Health Care.

While a raised PSA can be a sign of prostate cancer, it may also be an indication of the presence of a urinary tract infection or be caused by recent sex, and if not well analysed, can easily produce a false positive for prostate cancer.

Over-diagnosis can also occur, especially when the “cancer” detected will not cause symptoms or death. Consequently, according to the task force, 11 per cent to 19 per cent of men who are told they have prostate cancer after PSA screening would not have it in their lifetime.

In other cases, between 40 per cent and 56 per cent will be over-diagnosed, meaning the patients are told they have the disease though their condition will not cause them symptoms or even early death.

“The rate of false-positive results varies depending on the PSA test threshold, ranging from 11.3 per cent of all screened men at a threshold of 4.0 nanogrammes per millilitre (ng/mL) to 19.8 per cent at a threshold of 3.0 ng/mL,” the study says.

As a result, given the current state of knowledge, the task force recommends that the PSA test be avoided as a measure for cancer screening, especially for men aged less than 55 years and those 70 years and older, adding that the potential harm of screening outweighs the benefit.

PSA is one of the most common screening measures for prostate cancer in both the developed and developing nations. It is also commonly used in East Africa, and many middle-aged men who have visited hospitals to seek medical advice on prostate cancer have undergone the PSA tests.

In the recent years, prostate cancer has become the most common cancer among men in East Africa and has been on the rise as modernisation and sedentary lifestyles take root.

READ: Kikwete undergoes surgery in US

In Kenya, for example, prostate cancer is the most common form of cancer among men, ahead of kaposi’s sarcoma (a rare type of cancer associated with herpesvirus) and HIV-associated skin cancer. 

At least 1,000 new cases are diagnosed each year in Kenya, according to the Health Ministry records, while in Uganda, the Uganda Cancer Institute puts the figure at more than 1,500.

Increased burden

In Tanzania, according to Prostate Cancer Africa, a website managed by the US-based Prostate Cancer International, which carries basic information on the disease, every year, some 1,200 to 1,300 men are diagnosed with prostate cancer. In Rwanda, about 100 individuals are diagnosed annually while in Burundi 147 new cases are recorded each year.