Breast self-examination a waste of time, says cancer registry chief

‘Little evidence’ annual prostate tests improve survival chances, says Harry Comber


Regular breast self-examination is a “waste of time” in the early detection of breast cancer, while there is “very little evidence” that annual prostate-specific antigen (PSA) tests have any impact on improving chances of survival from prostate cancer, according the director of the National Cancer Registry (NCR).

Dr Harry Comber was speaking as the NCR published its annual report, which shows that the overall incidence of cancer is continuing to increase.

Breast cancer is still the most common cancer among women (32 per cent), while prostate cancer is the most common among men (31 per cent). The most prevalent cancers affecting both men and women are colorectal/bowel cancer (13 per cent) and lung cancer (11 per cent).

Asked whether regular self-examination of breasts by women was the best method of early detection, Dr Comber told The Irish Times: “In fact monthly examination of the breasts is something of a waste of time. As a screening method it doesn’t work. It only causes neurosis. There was a huge study carried out in Shanghai, involving hundreds of thousands of women in hundreds of factories where they had half the women examine their breasts regularly and the other half didn’t, and they found there was no difference at all in the survival rates from breast cancer.

“Of course women should be screened and they should generally be ‘breast aware’, but it seems to be the case that by the time the breast has a lump you would detect on self-examination, it is already too late for early intervention.”

He said the key indicator for prostate cancer was passing blood in the urine. “There is very little evidence that PSA tests have any role in improving survival rates.”

A PSA test measures the level of the antigen in the blood. An elevated level is said to be an indicator of prostate cancer. However, there were numerous reasons why a man’s PSA might be elevated, Dr Comber said.

“There has been a lot of media energy put into telling men to have regular PSA tests and it has led many men to go off and have unnecessary interventions and tests after having the test. The key things to look out for are blood in the urine, difficulty urinating, pain urinating.”