Rise in Aggressive Prostate Cancer Linked to Screening lapses, Research suggests
Toronto – A growing body of evidence suggests a surge in diagnoses of aggressive, incurable prostate cancer may be linked to decreased early screening rates, prompting renewed debate over the benefits and risks of prostate-specific antigen (PSA) testing. While official screening guidelines remain under review, experts warn that delays in detection could be leading to more men facing advanced stages of the disease with limited treatment options.
The concern stems from a pattern observed by researchers and clinicians, including Dr. Ritika Gyawali, who notes a shift towards identifying more advanced prostate cancers. “We’re seeing more men present with cancer that has already spread, making it much harder to treat effectively,” she said.This trend coincides with periods where PSA screening recommendations were questioned, leading to reduced uptake among eligible men.
Denis Farbstein, 54, who underwent prostate cancer surgery after being screened, believes early detection saved his life. ”Had I not been screened, it could have gone into other parts of my body, and then I would have been in trouble. So,for me,personally,I was very blessed,” he said from a Toronto clinic where he volunteers,helping newly diagnosed patients.
However, the issue is complex. Experts acknowledge that PSA screening isn’t perfect, and can lead to overdiagnosis and overtreatment of slow-growing cancers that may never pose a threat. “There are so manny people who have these benign cancers who undergo these procedures, but some of them end up suffering the complications of those procedures for the rest of their life,” said Gyawali. “But even these people will always look back upon their screening as something that was the right thing that they have done.”
The Canadian task Force on Preventive Health Care, responsible for developing national cancer screening guidelines, is currently undergoing an external review, pausing work on all updates, including those for prostate cancer. This means current guidance remains unchanged, leaving a gap in clarity for both physicians and patients.
Both the Canadian Cancer Society and the Canadian Urological Association currently advocate for PSA screening, but emphasize the importance of a thorough discussion with a doctor to weigh the potential harms and benefits. Updated guidance is expected next year, but the timing remains uncertain. The debate underscores the ongoing challenge of balancing the potential for early detection against the risks of needless intervention in prostate cancer management.
