The Prostate Cancer Centre’s stance on PSA testing
September 2017
Prostate specific antigen (PSA) screening has been a confusing issue for men for many years. The varied and constantly changing guidelines put forth by the United States Preventative Services Task Force and the Canadian Task Force on Preventive Health as well as several other professional associations on the risks of early screening have men and their family physicians asking themselves whether it is important to get checked or not.
At the Prostate Cancer Centre we are continuing to encourage men to be properly informed and educated when it comes to prostate cancer screening.
Since the introduction of PSA screening in the United States in the 1990s there has been a >50% reduction in prostate cancer mortality and a >70% reduction in metastatic disease from prostate cancer.1
A recently published study in the Annals of Internal Medicine confirms that PSA testing reduces the risk of death from prostate cancer by up to 32%2
confirming that PSA screening remains an important tool in diagnosing and treating prostate cancer. When detected early, prostate cancer has a >95% survival rate in the first 5 years.3
Over the past 10 years, we have developed a great appreciation of the harms of over-treatment for prostate cancer. While some prostate cancers grow rapidly and metastasize, or spread, others grow slowly and are unlikely to metastasize. The proportion of surgeries performed for low-risk prostate cancer in Calgary has decreased from close to 60% to <10% over the past 10 years.
The majority of men diagnosed with low-risk prostate cancer in Calgary are offered active surveillance with treatment offered only when there is evidence of progression. Studies show that the majority of men with low-risk prostate cancer can be safely observed for up to 5-10 years without need for intervention.
Over-treatment of men with low-grade cancer is not an issue in Calgary. We are proud to be setting a national standard for supportive care before and after treatment at the Prostate Cancer Centre, and are also leveraging PSA screening to empower men to be more involved in their overall health.
We would welcome anyone to come to the Prostate Cancer Centre and talk to any one of our Urologists, staff, or patients working in the field of prostate cancer to see the clinical work that is being provided to our patients and their families.
Kevin V Carlson, MD, FRCSC, DABU
Clinical Associate Professor and Section Head of Urology Department of Surgery, Cumming School of Medicine University of Calgary
Geoffrey Gotto, MD, MPH, FRCSC
Clinical Associate Professor
Department of Surgery, Cumming School of Medicine, University of Calgary
Bryan Donnelly, MD, MSc, FRCSC
Clinical Associate Professor
Department of Surgery, Cumming School of Medicine, University of Calgary, Co-Founder of Calgary’s Prostate Cancer Centre
Eric Hyndman, MD, PhD, FRCSC
Clinical Assistant Professor
Department of Surgery, Cumming School of Medicine, University of Calgary
References:
1.Downloaded From: http://oncology.jamanetwork.com/ by a University of California – San Diego User on 12/29/2016
2.Tsodikov A, Gulati R, Heijnsdijk EA, Pinsky PF, Moss SM, Qiu S, et al. Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials. Ann Intern Med. [Epub ahead of print 5 September 2017] doi: 10.7326/M16-2586
3.Canadian Cancer Society: http://www.cancer.ca/en/cancer-information/cancer-type/prostate/prognosis-and-survival/survial-sttistics/?region=on