TORONTO – Men should get a baseline prostate cancer test in their 40s instead of waiting until their 50s, according to new recommendations released Wednesday by Prostate Cancer Canada (PCC).
According to PCC, the updated guidelines will empower Canadian males to take a more active role in monitoring their number one cancer risk and will “help to relieve confusion, uncertainty and fear among Canadian men.”
The PSA—or Prostate Specific Antigen—test is a blood examination that measures that amount of prostate specific antigen in your blood. While there are controversies about the effectiveness of the test, PCC said high numbers serve a powerful red flag for further investigation.
“PSA levels can vary between individuals so a test in the early 40’s can provide a baseline and allow us to better tailor clinical follow-up,” said Dr. Rajiv Singal, urologist at Toronto East General Hospital and assistant professor at the University of Toronto. “The PSA is an important marker for a disease in which symptoms are not always present.”
In 2011, a committee of scientists in the United States said routine PSA testing doesn’t lead to appreciable reduction in deaths and that the tests can lead to biopsies that are false alarms, or treatments that leave many men incontinent or impotent for non-fatal cancers.
READ MORE: PSA test critical tool for prostate cancer diagnosis despite criticism: group
PSA testing is primarily a means of monitoring prostate health and one abnormal test result does not mean leaping into treatment.
The risk for prostate cancer increases with age and men of black African or black Caribbean descent have a higher risk.
Men who also have a first degree relative, such as a brother, father or son, with prostate cancer also have an increased chance of getting the disease.
Last month, the Canadian Cancer Society launched a nationwide video and social media campaign dubbed “Nutiquette: a dude’s guide to checking his nuts” to teach men how to spot testicular cancer early.
READ MORE: There’s etiquette for everything, including testicles
Prostate cancer is the most common cancer to affect Canadian men, impacting one in seven men over the course of their lifetime.
VIDEO: Prostate Cancer Canada’s #KnowYourNumber
Canadian men ‘uncertain’ about risks, what to do
A recent nationwide poll by PCC found that most men, regardless of their age, are uneducated about prostate cancer. Of those surveyed, 55 per cent of men 18 years of age and over either didn’t know or under-estimated a man’s lifetime risk of developing prostate cancer.
The survey also found that 85 per cent of Canadian men 35 and older feared getting prostate cancer, less than half anticipate being tested in the next 12 months—even though early diagnosis can increase the odds of survival.
“We fully appreciate that men may be fearful of the process – but without a quick check, we can’t know what are dealing with,” said Dr. Singal. “It is critical to their health and well-being that Canadian men be aware, talk to their doctors and get tested.”
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Talking about prostate cancer
When patient Garrick Tiplady turned 40, he knew it was important for him to get the PSA test.
“With the history that my family has, it was quite reassuring to know everything was within the normal perimeters,” Tiplady said in an interview with PCC. “Now I’ve got a baseline I can go back to year-after-year and really get a sense of where I stand.”
Singal, however, recommends that men at high risk should talk to their primary care provider even earlier than their 40s.
“In my 18 years of practice, the majority of aggressive cancers have been found in men with seemingly no risk factors – underscoring the importance of baseline testing,” he said.
Getting tested over 70
Dr. Stuart Edmonds for PCC said the decision to end PSA testing for men aged 70 years and over should also be based on individual factors, rather than an arbitrary cut-off age.
“Men are living longer and their lives should not be cut short or diminished by prostate cancer,” he said. “The decision to end testing should be a shared decision determined by a man and his primary care provider.”
– With a file from Adam Frisk, Global News
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