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Monday, 15 September 2008 19:52

Australia studies talk knowledge, incidence, mortality of prostate cancer

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The first Australian study shows that men don’t know much about prostate cancer, and the second article states that a dramatic increase in prostate cancer incidence, but a decrease in deaths, was found in New South Wales after PSA testing was begun.


The authors of the first article, which is found in The Medical Journal of Australia (MJA), discovered that the men at the most risk of getting prostate cancer do not know very much about the cancer.

Such ignorance of the disease likely causes delayed diagnosis and treatment of prostate cancer, according to the study.

The second article stated that the authors found the incidence of prostate cancer went up drastically in New South Wales after prostate-specific antigen (PSA) testing was started in 1988, but deaths from the cancer went down.

Both articles are published in the September 15, 2008 issue of the The Medical Journal of Australia.

ARTICLE ONE

The first MJA article “Knowledge and attitudes of men about prostate cancer” talks about the level of understanding among older Australian men concerning prostate cancer, along with its possible side effects and various treatment options.

The authors of the article are Diane E. Arnold-Reed, Dana A Hince, Max K. Bulsara, Hanh Ngo, Michael Eaton, Alan R. Wright, Frank R. Jones, Walter Kaczmarczyk, Andreas G. Marangou, and Thomas D. Brett.

The research study looked at 503 men between the ages of 40 and 80 years, who were located in the Perth metropolitan and regional areas of Western Australia.

Some of the men had prostate cancer, while others did not. They were surveyed through a questionnaire while going in for regular medical checkups with their doctors.

The results of the first study is found on page two.




The results of the study found that 80% of the men surveyed did not know the function of the prostate.

The study also discovered that 48% of the men did not know that prostate cancer is the most common internal cancer in Australian men. (Skin cancer is the most common cancer among men in Australia, being an external cancer.)

The incidence of prostate cancer in Australia goes up drastically after the age of 65 years, and the incidence of death from prostate cancer in Australia goes up dramatically after the age of 70 years.

In addition, 35% of the men did not have any appreciable knowledge of the various treatments for prostate cancer.

Fifty-three percent (53%) of the men could not describe nor did not have any knowledge of the side effects of the treatments for prostate cancer.

The paper states, “Asked how they would arrive at a decision about treatment, 70% said they would ask the GP [general practitioner] or specialist for information on all their options and then decide themselves."

The lead researchers of the study are Diane Arnold-Reed and Alan Wright, both associated with the School of Medicine at the University of Notre Dame Australia.

What did the authors conclude in their study? Please read page three.




Wright stated, “Knowledge concerning prostate cancer was generally poor, but previous exposure increased knowledge of treatment options and side effects.” [AMA: “What Men Know About Prostate Cancer”]

The authors concluded in their paper, “There is a deficit in knowledge about prostate cancer among men in the at-risk age group, encompassing areas that could delay diagnosis and treatment. Overall, the men preferred some GP or specialist involvement in treatment decision making."

Wright added, “Despite the availability of good factual information for patients, GPs still play a central role in the provision of information to at-risk ageing men about the high-technology tests and treatment options that many will inevitably face.” [AMA]

ARTICLE TWO

The second MJA article is entitled “Prostate cancer and prostate-specific antigen testing in New South Wales.” Its authors are David P Smith, Rajah Supramaniam, Villis R Marshall, and Bruce K Armstrong.

This article discusses prostate-specific antigen (PSA) testing in New South Wales, along with the incidence and mortality of prostate cancer in NSW.

The researchers used data from PSA testing undertaken between 1989 and 2006, and statistics from prostate cancer cases and deaths from 1972 to 2005, both in New South Wales.

The study found that the PSA tests conducted from 1994 to 2006 more than doubled in numbers.

In addition, the incidence of prostate cancer reached its maximum level in 1994, dropped by approximately 10% for each of the next four years. Then, between 2001 and 2005, the incidence of prostate cancer increased by about 4.9% each year.

The abstract to their paper states, “An estimated 19,602 (43%) more men than expected from preceding trends were diagnosed with prostate cancer between 1989 and 2005 after PSA testing was introduced.”

The authors added, “The incidence of recorded advanced prostate cancer at diagnosis fell from 13.0 per 100,000 men in 1987–1991 to 7.0 per 100,000 men in 2002–2005. The age-standardised mortality from prostate cancer increased by 3.6% per year between 1984 and 1990 and then fell by 2.0% per year to 2005.”

What did Dr. David Smith, the lead researcher of the study state? Please read page four.




David Smith, from the Cancer Council NSW, was the lead researcher in the study.

Smith stated, “Whatever its cause, the downward trend in prostate cancer mortality is clearly favourable; the upward trend in incidence may be less so…. Embracing PSA testing as a de facto population-wide screening test has probably resulted in benefits for some men diagnosed with earlier-stage disease but harm for others who were over-diagnosed [with cancers that would never otherwise present clinically].” [AMA]

The conclusions of the authors from their research were summarized in their abstract as: “There was a sustained increase in prostate cancer incidence in NSW after PSA testing was introduced. While falls in the incidence of advanced disease at diagnosis and mortality from prostate cancer after 1993 are consistent with a benefit from PSA testing, other explanations cannot be excluded.”

Additional information about prostate cancer is found at the U.S. National Cancer Institute and the Prostate Cancer Foundation of Australia .

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