Top urologist calls for more research and more clarity on prostate tests

One of Britain's top urologists called for the medical profession and health charities to provide clearer public information on a test used to help detect prostate cancer. Speaking at the Great PSA Debate in Leamington Spa recently Professor Roger Kirby, Director of the Prostate Centre in London also called for more research into ways of testing for prostate disease.

The PSA test is a simple blood test that measures the amount of prostate specific antigen (PSA) in the bloodstream but its use is hugely controversial. Although men are more likely to have a benign prostate disease than cancer, symptomless early stage prostate cancer is generally first detected by means of the PSA test. However, the number of false positives and missed diagnoses of prostate cancer still raises questions about its usefulness. In a lively debate organised by the patient group the Prostate Cancer Support Federation and supported by Prostate UK, the pros and cons were presented by a panel of experts before the audience was asked to vote on the motion ‘Every man at risk of prostate disease (ie men over 50, or 40 for men with other risk factors) should be encouraged to check his PSA every year’.

‘The PSA test is the beginning of a man’s journey into learning about the health of his prostate. We need to improve this and every subsequent step with more research and more clarity’, said Professor Kirby.

Although there were still some differences of opinion about the test, it was agreed that men are largely ignorant about their prostate health, despite 10,000 men dying of prostate cancer every year. It was also agreed that there is a gap in GP knowledge about how to treat prostate disease and charities such as Prostate UK should continue to try and fill this gap with training seminars where possible. Despite the PSA test being first introduced 30 years ago, there is still no alternative proven to be more effective for testing prostate health. The panel all agreed more research was needed.

Amanda McLean, Chief Executive of Prostate UK, said in her closing remarks ‘Much more work is needed to raise awareness of prostate disease and how men access the information they need to make informed choices about their wellbeing. Prostate UK will be arranging a meeting with the other prostate charities to see how we can work together on this.’

John Neate of the Prostate Cancer Charity said ‘Speaking with a common voice is essential’.
The motion was carried by a large majority. A revised motion was then put to the floor and was carried almost unanimously: ‘Every man at risk of prostate disease (ie. men over 50, or 40 for men with other risk factors) should be made aware of the PSA test, its benefits and limitations and should be able to freely exercise his right to have it’.

The results of the debate will be passed to the National Screening Committee to inform their recommendations on prostate cancer screening, in spring  2010.