death in men... - Urological Society of Australia and New Zealand

Media Release 9 th September, 2010Urologists reject report findings on PSA testingThe peak body representing specialists treating prostate cancer, the UrologicalSociety of Australia and New Zealand, has challenged comments critical of prostatespecific antigen blood testing as misguided and ill-founded.The report “Assessing Cost-Effectiveness in Prevention” which was produced byuniversity researchers and funded by the National Health and Medical ResearchCouncil, was critical of PSA testing, currently the best available means of detection ofincreased risk of prostate cancer – one of the leading causes of preventable death inmen.The report, released on September the 8 th , claimed that “a large proportion of falsepositive test results means a greater number of expensive and unpleasant follow-updiagnostic procedures and, in some cases, unnecessarily aggressive treatments for adisease that may never have given symptoms during an individual’s lifetime. Theseharmful effects are greater than the modest population health gain from detecting truecases of prostate cancer.” Furthermore, the report recommended a halt to using thetest in asymptomatic men and a redirection of resources to “more favourableinterventions.”“Whilst we welcome the general purpose of the report, which was to evaluate theeffectiveness of a comprehensive array of health prevention measures, we regret thatthe comments and assertions made regarding PSA testing as resulting in more harmthan benefit are simply not based a reasoned assessment of the facts,” said Societypresident, Dr David Malouf.“There is firm data that PSA testing reduces the risk of being diagnosed withadvanced disease, and that treating prostate cancers following diagnosis can lead toa reduced risk of dying from the disease compared to no treatment,” he said.The European Randomised Study for Prostate Cancer (ERSPC), conducted in sevencountries, showed a 31% reduction in cancer mortality in men aged 55-69 years whounderwent routine screening. Now, further evidence from Sweden published inLancet Oncology with longer follow-up, suggests that PSA screening for prostatecancer may reduce prostate cancer deaths by up to 44%.“While some commentators have argued that many indolent cancers areunnecessarily detected as part of a screening process, in practice many of these mencan be reassured that they have low risk disease and simply monitored without activetreatment in the medium to long term,” Dr Malouf said.Routine population based prostate cancer screening with the PSA blood test is notperformed in Australia or New Zealand and is, at present, not advocated by theSociety.

2“The position of the Urological Society of Australia and New Zealand remains thatpatients should have access to PSA based testing if they wish, after discussion withtheir family doctors and/or specialists about the risks and benefits of such testing.Dr Malouf said access to appropriate testing for prostate cancer, one of the leadingcauses of male cancer deaths is equally as important as women having access totesting for breast cancer and any proposal to cut funding may cost lives.Dr Malouf said the limitations of PSA testing underscore the importance ofdeveloping new tests to identify aggressive forms of prostate cancer and differentiatethem from more slowly growing tumours. Such a test will enable treatment to focuson men whose cancers pose a threat to their health and avoid over-treatment of menwith the more indolent forms of the disease. Until then, PSA is the best test we haveand when used appropriately it is a very powerful tool in the fight against prostatecancer,” he said.Media enquiries:Edwina GatenbyMaxicom Public RelationsPhone: 61 2 99659300Mobile: 0402 130 254 (61 402 130 254 if calling from NZ)