Although prostate cancer kills 2,500 Australian men each year, there is still controversy about whether men without symptoms should be tested for the disease (screening). It is important to consider both the pros and cons of testing and to discuss your decision with your GP.

Two tests are used for screening: a PSA test (a simple blood test) and a rectal examination, in which the doctor inserts a gloved finger in the anus (bottom).

Annual testing may be considered for men aged between 50 - 70 (with at least a 10 year life expectancy). Men with a family history of prostate cancer (such as a father or brother with the disease) are at higher risk and should be tested from age 40.

Men with symptoms, such as frequent or urgent urination, a weak stream, or blood in the urine or semen, should inform their doctor and will require investigation.

Reasons for screening

• Cancers detected by screening are smaller and have a better chance of cure. There are also fewer side effects from the treatment of early cancers. 
• The recent fall in the death rate and in the number of cases of advanced cancer may be due to screening.

Reasons against screening 

• If a cancer is found, many older men will die from other causes anyway and not from the cancer. These men will therefore have had unnecessary treatment and may suffer side effects, such as impotence and incontinence, as a result. 
• Testing is not always accurate. Three in 4 men with a raised PSA test will NOT have cancer and will suffer the anxiety and risks of a biopsy (a small operation to take a sample) unnecessarily. 
• We are still waiting for the results of international trials for proof that widespread screening actually reduces the death rate from prostate cancer.

For more information, go to http://www.prostate.com.au/.