PSAs may pose dangers regarding prostate exams

‘Movember’ may need to seek better testing methods

By Angela Espinoza, News Editor

For the past decade, November has served as a month of awareness regarding prostate exams. “Movember,” as the month is nicknamed, sees men each year grow moustaches to raise money and help seek better cures for prostate cancer.

This year’s Movember health movement is pushed by recent claims that the prostate-specific antigen (PSA) test, the most common form of checking for prostate cancer, may actually be frequently inaccurate. The Canadian Task Force on Preventative Health Care (CTFPHC), a volunteer medical panel, published on October 27 an article and condensed statement stating that those over the age of 55 should not receive PSAs when testing for prostate cancer.

The condensed version specifies that those who have been tested between the ages of 55 and 69 have experienced “moderate quality evidence” in testing for cancer. CTFPHC defends that there has been conflicting evidence in the past that PSAs provide accurate information regarding the state of men’s prostates, and have been incorrect often enough that the tests now present the group with cause for concern.

James Dickinson, a University of Calgary professor of Family Medicine and Community Health Sciences, told CBC, “Despite 20 years, the amount of evidence [regarding accuracy] that’s been brought forward is disappointingly small.” Dickinson, who is also a member of CTFPHC, added, “The enthusiasts are enthusiastic despite minimal evidence.”

The statement reported that the group’s main cause for concern is over-positivity; testing that frequently ends in a wrongly positive result. As such, more men are being treated for prostate cancer they may not even have.

However, Prostate Cancer Canada defends the usefulness and otherwise accuracy of PSAs when testing patients for the disease. Prostate Cancer Canada’s Stuart Edmonds told CBC, “PSA isn’t the bad actor in this, it’s actually decision-making along the process that’s part of the problem, how the PSA is being interpreted or how men are being pushed or choosing to have treatment when actually treatment may not be necessary.”

Besides PSAs, digital rectal exams are the next leading tool in testing for prostate cancer. There is also currently research looking into whether or not magnetic resonance imaging (MRIs) can be used to test patients for prostate cancer. MRIs are currently best-used in detecting more aggressive forms of prostate cancer.

After skin cancers, prostate cancer is the most common cancer to occur in men, and the third highest cause of cancer-related death for men in Canada. To get involved in fighting against prostate cancer, visit Canada’s Movember site ca.movember.com/