Publication on Asymptomatic Men

Proactively engaging with men at high risk about the PSA blood test rather than waiting for symptoms, is crucial for earlier diagnosis and management.   

Men at high risk include:   

• Men aged 50- 70    
• Black men aged 45-70  
• Men with a recorded family history of prostate or breast cancer aged 45 –70  

A paper by Gnananpragasam, Greenberg and Burnet (2022) found that symptoms do not equal risk of prostate cancer diagnosis but rather:   

• Men shouldn’t wait for urinary tract symptoms: Waiting for troublesome lower urinary tract symptoms as a trigger to see a GP about prostate cancer may potentially delay earlier diagnosis and management.   
• No causal link with prostate cancer and urinary symptoms and evidence points to an inverse correlation: There is no evidence of a causal link between prostate cancer and either prostate size or troublesome male urinary symptoms. In fact, most evidence points to an inverse correlation.  
• PSA testing should be encouraged in at-risk men: Modern image-based diagnostics and risk-adapted management strategies have reduced the risks of over-investigation and over-treatment which previously deterred greater promotion of PSA testing in men with no symptoms.   
• Curable prostate cancer is asymptomatic: It is now timely to re-brand early, curable prostate cancer as primarily an asymptomatic disease to encourage more men to come forward and get tested earlier.   

Read paper in full

References

Gnanapragasam VJ, Greenberg D, Burnet N. Urinary symptoms and prostate cancer—the misconception that may be preventing earlier presentation and better survival outcomes. BMC Medicine. Published online August 4, 2022. Accessed January 6, 2023. doi.org/10.1186/s12916-022-02453-7   

You may be interested in:

NICE NG12 Guidelines

You may be interested in:

PCN DES