Madam, – A headline in your edition of February 18th – “Cancer tests have not cut death rate, says consultant” – sends an unfortunate message that prostate cancer screening using the prostate specific antigen (PSA) blood test is somehow not worthwhile.
Dr Alan Smith claims that the increased use of PSA screening has not reduced prostate cancer mortality rates in Ireland. However, in the US, where PSA testing has been in widespread use for many more years, death rates from prostate cancer have dropped by over 30 per cent since its introduction. The National Cancer Research Institute predicts that the number of newly diagnosed prostate cancer patients in Ireland will increase from 2,400 in 2005 to over 6,500 in 2035. This will inevitably add to the toll of 600 deaths from prostate cancer each year. Early diagnosis will clearly lead to improved cancer cure rates, and improvements in surgical techniques have already led to great improvements in outcomes following radical prostatectomy.
While the argument for population-based screening for prostate cancer (similar to breast cancer screening) has yet to be settled, this should not discourage men aged 45 and upwards from discussing the pros and cons of PSA testing with their GP. This advice is supported by the Irish Cancer Society and many other professional bodies worldwide. We have a public health duty to ensure this message is communicated to Irish men, especially to those at higher risk.
Headlines such as yours this week are not helpful in this regard. – Yours, etc,