Smarter Screening. Smarter Treatment.
Research and Innovations In Canada, about one in eight men will be diagnosed with prostate cancer in their lifetime, but many of these cancers are low-risk and require minimal treatment or no treatment at all.
In Canada, about one in eight men will be diagnosed with prostate cancer in their lifetime, but many of these cancers are low-risk and require minimal treatment or no treatment at all. In fact, there is substantial concern about overtreatment and overdiagnosis of asymptomatic cancers.
This makes the question of when and how to screen for prostate cancer an important one. As new data, and new analyses of old data, continue to come in, the Canadian Urological Association (CUA) is updating their guidelines for prostate cancer screening. “We feel that there is enough new data to make the guidelines clearer,” says urologist and CUA officer Ricardo Rendon of Halifax. “It’s not just about when to screen but also how to do it. It’s what we call smarter screening.”
The new recommendations suggest screening for men over the age of 45, or over 40 for those considered to be high-risk. It also recommends that men over the age of 60 no longer be screened if their prostate-specific antigen (PSA) levels are 1 or less, or if they are above 70–75 years of age. It’s part of a general move toward incorporating a wider variety of risk factors into the screening process. “Instead of making decisions based on only one piece of information, PSA, we are recommending the consideration of many different variables — including age and family history — to determine a more accurate cancer risk factor,” says Dr. Rendon. “We call these nomograms, and they are much better than using PSA alone.”
For Canadian men who fall into the categories recommended for screening, the most important thing is to understand that screening doesn’t need to be intimidating. “I tell my patients that we’re looking for prostate cancer, but chances are you will have no cancer or a very low-risk cancer that we’ll simply watch rather than immediately treat,” says Dr. Rendon. “And for the cancers that do need to be treated right away, we have very good survival outcomes. It’s better to know than to not know. Don’t be scared, be empowered by the knowledge.”