{"id":38466,"date":"2025-08-01T03:43:37","date_gmt":"2025-08-01T03:43:37","guid":{"rendered":"https:\/\/www.newsbeep.com\/ca\/38466\/"},"modified":"2025-08-01T03:43:37","modified_gmt":"2025-08-01T03:43:37","slug":"prostate-cancer-screening-should-focus-on-those-with-elevated-risks-experts-say","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ca\/38466\/","title":{"rendered":"Prostate cancer screening should focus on those with elevated risks, experts say"},"content":{"rendered":"

Open this photo in gallery:<\/a><\/p>\n

Rensford De Haan heard about the free PSA testing clinic and took a blood test in 2023, which showed his PSA level was elevated. A biopsy later revealed he had prostate cancer.Shay Conroy\/The Globe and Mail<\/p>\n

Canada should rethink its approach to prostate cancer screening, which uses a controversial blood test that an expert task force encouraged doctors to abandon more than a decade ago, according to a new paper led by a group of Toronto urologists and oncologists.<\/p>\n

In an article published Friday in The Lancet Regional Health \u2013 Americas, the authors argue for a population-wide trial that would offer the blood test, known as the prostate-specific antigen test, or PSA test, to men at elevated risk of prostate cancer, likely including Black men and those with a family history of the disease. <\/p>\n

The goal would be to provide PSA testing to high-risk men through the public health system, while also trying to settle a decades-long fight over whether the risks arising from the PSA test outweigh the test\u2019s usefulness in catching aggressive cancer early.<\/p>\n

In Canada, access to prostate cancer screening often depends on whether a man has a family doctor who supports the PSA test and whether, in some provinces, he can afford to pay for the test, said co-author David-Dan Nguyen, a urology resident and doctoral student studying clinical epidemiology at the Institute of Health Policy, Management and Evaluation at the University of Toronto. <\/p>\n

\u201cWhat we believe should be the case,\u201d Dr. Nguyen said, \u201cis that it should entirely instead depend on your risk profile.\u201d<\/p>\n

Dr. Nguyen and his co-authors are making their case at a moment of flux for cancer screening policy in Canada. <\/p>\n

When and how should I be screened for prostate cancer?<\/a><\/p>\n

In March, former health minister Mark Holland ordered the Canadian Task Force on Preventive Health Care, an independent panel that crafts cancer screening guidelines, to halt its work<\/a> until a group of external experts could finish a review of the task force\u2019s governance and processes. <\/p>\n

The 15-member task force found itself in the political crosshairs largely because it declined to lower the recommended starting age<\/a> for routine mammograms to 40 from 50, raising the ire of breast-cancer doctors and patient advocates. <\/p>\n

The 104-page external review<\/a>, led by University of Waterloo president Vivek Goel, was published last month. It recommended the task force be \u201cmodernized.\u201d Mr. Holland\u2019s successor, Marjorie Michel, said she wanted a revamped task force up and running by April of next year. <\/p>\n

In the meantime, updates to some cancer screening recommendations are in limbo, including work on a new version of the 2014 prostate guideline<\/a> that recommended against the PSA test as a screening tool.<\/p>\n

Prostate-specific antigen is a protein produced by the cells of the prostate, a walnut-size gland that is part of the male reproductive system. The test searches for the nanograms of PSA in a millilitre of blood. If the number is higher than expected, it can be an early sign of prostate cancer.<\/p>\n

Critics of the test say it puts men on a path to overdiagnosis and overtreatment of slow-growing tumours that might never have caused harm. <\/p>\n

For some prostate cancer patients, new treatment option offers relief \u2013 and hope<\/a><\/p>\n

\u201cI can tell you a story from my own practice,\u201d said Roland Grad, a former member of the Canadian Task Force on Preventive Health Care and a family doctor. \u201cI screened a man in his 60s, and we found a cancer. He went on to have surgery, and he developed incontinence and impotence.\u201d <\/p>\n

A pathologist who examined the man\u2019s prostate after it was removed concluded the cancer wasn\u2019t as dangerous as the biopsy made it seem. <\/p>\n

\u201cHe probably didn\u2019t need the surgery in the first place and then he suffered these complications which really affected his quality of life,\u201d said Dr. Grad, who is also a physician-scientist at McGill. <\/p>\n

Although Dr. Grad stepped down from the task force in 2023, he has continued to work on a systematic review of the latest evidence around prostate cancer screening, which is supposed to underpin a revised Canadian recommendation. <\/p>\n

It\u2019s not clear when a new guideline on prostate cancer screening will be published because of the upheaval imposed on the task force.<\/p>\n

Neil Fleshner, a urologic oncologist at Princess Margaret Cancer Centre, which is part of University Health Network, regards the 2014 recommendation against PSA testing as a \u201ctravesty.\u201d <\/p>\n

He said the guideline authors failed to acknowledge that \u201cactive surveillance,\u201d where low-grade prostate cancer is monitored rather than hastily operated upon, was already commonplace when the negative recommendation was released. <\/p>\n

That is why Princess Margaret and the Walnut Foundation, a Black men\u2019s health group, have begun operating mobile clinics that offer free PSA testing to men in Black communities in the Greater Toronto Area, where prostate cancer risk can be high and access to doctors low. <\/p>\n

Dr. Fleshner and his team have screened 655 men at 11 clinics since 2023, 16 per cent of whom required follow-up. <\/p>\n

One of those men was Rensford De Haan, a 56 year old of Guyanese descent who lives in Oshawa and heard about the free PSA testing clinic through his Scarborough church. <\/p>\n

A blood test taken on Father\u2019s Day weekend in 2023 showed his PSA level was elevated. A biopsy later revealed he had prostate cancer, which led him to choose surgery last fall. <\/p>\n

Mr. De Haan doesn\u2019t downplay how difficult it is to recover from prostate surgery. But he thinks more men, especially from his own community, should get screened. <\/p>\n

\u201cThe alternative to not knowing early is knowing when it\u2019s too late,\u201d he said. <\/p>\n","protected":false},"excerpt":{"rendered":"Open this photo in gallery: Rensford De Haan heard about the free PSA testing clinic and took a…\n","protected":false},"author":2,"featured_media":38467,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[901,888,902,879,877,903,49,48,876,895,896,891,878,875,46,549,295,894,887,914,880,881,893,84,392,889,890,884,904,885,909,910,912,907,911,905,908,882,898,899,714,897,906,865,61,900,892,886,883,913],"class_list":["post-38466","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-alberta","tag-arts-news","tag-bc","tag-breaking-news","tag-breaking-news-video","tag-british-columbia","tag-ca","tag-canada","tag-canada-news","tag-canada-sports","tag-canada-sports-news","tag-canada-trafficcanada-weather","tag-canadian-breaking-news","tag-canadian-news","tag-economy","tag-education","tag-environment","tag-federal-government","tag-foreign-news","tag-globe-and-mail","tag-globe-and-mail-breaking-news","tag-globe-and-mail-canada-news","tag-government","tag-health","tag-healthcare","tag-life-news","tag-lifestyle","tag-local-news","tag-manitoba","tag-national-news","tag-new-brunswick","tag-newfoundland-and-labrador","tag-northwest-territories","tag-nova-scotia","tag-nunavut","tag-ontario","tag-pei","tag-photos","tag-political-news","tag-political-opinion","tag-politics","tag-politics-news","tag-quebec","tag-sports-news","tag-technology","tag-travel","tag-trudeau","tag-us-news","tag-world-news","tag-yukon"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/38466","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/comments?post=38466"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/38466\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media\/38467"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media?parent=38466"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/categories?post=38466"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/tags?post=38466"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}