Prostate cancer increased significantly in Europe, and widespread testing may be the reason

PROSTATE CANCER SMALL the number has actually swelled in Europe since the 1980s. However, according to a recent study, the statistics are darker than the reality.

The increase in the incidence of the disease is due to the widespread use of PSA testing. According to the study, unregulated screening produces “pointless” cancer diagnoses.

“You could even say that PSA testing caused the prostate cancer epidemic in Europe in the 1990s and 2000s,” says the professor of epidemiology Anssi Auvinen from the University of Tampere in the bulletin.

An international group, in which Auvin was also a part, refers to “overdiagnosis”. It means that the test finds cancers that do not cause symptoms or threaten the patient’s life during his lifetime.

PSA is a protein produced by prostate cells, which is also produced by prostate cancer cells. Likewise, for example, the prostate gland benign hyperplasia increases the concentration of the substance.

“What the more tests are done, the more cancers are found. The vast majority of cancers found with PSA testing do not progress during a man’s lifetime, so active treatment is not needed in these cases,” explains Auvinen.

Finding a slowly progressing prostate cancer can lead to unnecessary treatments, which in turn can even reduce the patient’s quality of life.

Finnish was not part of the material of the recent study. However, a corresponding increase in the number of detected prostate cancers has been observed here as well.

According to the release, the incidence of prostate cancer increased strongly until 2005 and decreased after that. Mortality from the disease has decreased in Finland since 1996. There are more detailed statistics in the Finnish Cancer Registry.

The study was published in a scientific journal British Medical Journalissa. The population-level analysis looked at 26 European countries. The study looked at the incidence and mortality from prostate cancer in men aged 35–85.

In European countries, there were clearly fewer deaths than new cancer diagnoses between 1980 and 2020. In several countries, the incidence of cancer was 5–10 times higher than the mortality rate. According to the researchers, the results must be interpreted with caution.

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“It is not acceptable to wait fifteen years for screening to begin.”

The population systematic screening has not been started in Finland or in most other countries. Prostate cancer is, for example, the most common cancer in Finland and ranks first in several other countries as well.

A professor is strongly in favor of systematic screening for the disease in the EU Hein Van Poppelwho serves as one of the presidents of the European Association of Urologists.

“It is not acceptable to wait fifteen years for the screening to begin,” says Van Poppel.

A professor from the Belgian University of Leuven gave a lecture recently Finnish Prostate Cancer Association (Propo) at the event in Helsinki.

According to Van Poppel, what speaks in favor of systematic screening is that it reduces mortality in the long-term follow-up of patients, and according to him, there should be no disagreement about this. He took as one example of Swedish researchaccording to which mortality was greatly reduced.

However, the goal is not to make healthy men patients, Van Poppel reminded in his lecture.

In screening, overdiagnosing must be avoided, such as taking a sample as soon as a certain PSA value is exceeded. According to Van Poppel, patient-specific risk should be determined based on age, among other things, and magnetic resonance imaging should be used.

Strong there is no research evidence for systematic screening of the population, Auvinen, on the other hand, tells HS in an email. There are several pilot studies on organizing screening in Europe.

To Tampere and the universities of Helsinki Pro Screen study recently showed that a new three-step screening can detect a significant number of prostate cancers requiring treatment.

First, a blood test was taken and, if necessary, another. The results of two blood tests indicated a risk of cancer in seven percent of the participants. They were invited for an MRI scan. In about half of these men, a suspicious area was found in the prostate, from which a sample was taken.

Cancer was found in about two percent of the participants in the study. Four per thousand men were diagnosed with clinically insignificant cancers.