A cancer charity says it makes financial sense to screen men born at high risk of developing prostate cancer when they reach the age of 45.

But Prostate Cancer Research also recognizes that more accurate tests will be needed to justify screening all men.

Unlike breast, bowel and cervical cancer, there is no prostate-cancer screening program in the UK.

Instead, men are under an obligation to request a blood test from their GP if they are over the age of 50.

next His recent terminal cancer diagnosisOlympic cyclist Sir Chris Hoy has called for more young men to be tested – including those with a family history of the disease – and The government has asked the NHS to re-examine the evidence.

The debate about prostate screening revolves between the harms of an imperfect test and the early detection of aggressive cancers in some men and the diagnosis and treatment of slow-growing tumors that may never impact a man’s health or lifespan. Will do.

The case is constantly reviewed for and against in the UK, with the most recent report from the National Screening Committee in 2020 stating that the harms were too great.

More updates are expected this year.

Despite more men dying from prostate cancer than women from breast cancer, there is no reliable test for this disease.

Blood tests Men over 50 can request their GP to measure prostate-specific antigen (PSA), which is released by the prostate, a small gland located below the bladder involved in the production of semen.

But PSA levels can be elevated for a number of reasons – including an enlarged prostate, inflammation or infection, recent vigorous exercise or sex – or may remain normal despite cancer.

And there are many types of prostate cancer – not all of which are fatal.

“Prostate cancers are those that grow so slowly that they won’t affect a man’s lifespan,” says GP Dr Margaret McCartney.

These are found in one in three men over the age of 50.

“And then you have a very small number of very aggressive prostate cancers that grow quickly and cause harm,” says Dr. McCartney.

Follow-up magnetic resonance imaging (MRI) scans and a tissue biopsy can help find out which men have cancer and need treatment — but some people are still getting treatment for something they never knew about. There will be no problem.

“Far more men get tested to find out what type of prostate cancer it is, but it won’t benefit them – that’s the problem,” says Dr McCartney.

Clinical trials have produced conflicting results regarding screening.

One, in Europe, says it saves lives.

The second, in the UK, shows greater marginal benefits.

And a third in America say it is not.

Professor 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.”

Screening means aggressive cancers can be treated before symptoms appear.

But trials show that testing large numbers of healthy men does harm – and once cancer is detected, even a low-risk one, it needs to be followed up.

Many men with low-risk cancers are simply monitored or begin “watchful waiting”—but a cancer diagnosis and the invasive tests involved have a psychological impact.

Professor Ahmed says that one in 10 of these men chooses radical surgery rather than worrying about whether their cancer will grow or not.

But this can leave them unable to maintain an erection – and a third spend the rest of their lives needing pads because their urine leaks.

Professor Ahmed told BBC Radio 4’s Inside Health programme: “At 47-48 years of age, if we’re talking about testing and diagnosing men at that age, it would be two or three of these kinds of symptoms. It’s decades.”

“So I would avoid diagnosing a low-risk disease.”

Much research in the field has focused on refining the process to reduce the harms of screening.

And Professor Ahmed is running change testTo compare the most promising technologies, efforts will be made starting next year.

But it may take 10 years to get the results.

In the meantime, prostate cancer research report Say, screening high-risk 45-69-year-olds – black men and those with a family history of the disease or a particular gene mutation – would yield economic benefits after accounting for treatment costs and the impact on working lives. caregivers

Oliver Kemp, chief executive of the charity, says, “Early detection and treatment of cancer outweighs the harms of over-treatment four times more.”

And another charity, Prostate Cancer UK, says the report supports its call for reform of “dangerously outdated NHS guidance, which is causing too many men to receive late, incurable diagnoses”.

Professor Frank Chinegvundoh, consultant urological surgeon at Barts Health NHS Trust, says: “It is very difficult to assess the risks and benefits.”

But he often sees men who could have been diagnosed earlier — and they may be relatively young, he says.

“We can do much better than what we are currently doing,” Professor Chingvundoh told Inside Health.

And he says black men — who have twice the risk of the disease — should consider getting a PSA test at age 40, especially if they have a strong family history of cancer.

But concerns were raised earlier this year that black men are at greater risk than other men Damage caused by a cancer diagnosis that did not need to be treated, because they have naturally high PSA levels,

While arguments rage, what should men do today?

“This is a really difficult question,” says Professor Ahmed.

And the NHS needs to keep people better informed.

The tradeoff between the risks and benefits of testing is “very subtle, very individual”, says Professor Ahmed, and what is acceptable to one man will be unacceptable to another.