Prostate cancer is the most common cancer in males, with approximately 413,000 new cases and 85,000 deaths in the Americas each year. The Caribbean countries, notably Barbados, Trinidad and Tobago, and Jamaica have the highest prostate cancer rates in the region.
Screening men for prostate cancer, with the PSA test, can reduce mortality by an estimated 20%-30%. However, PSA testing can lead to over-diagnosis in 20%-40% of cases. Therefore, there is a need for shared decision making in balancing harms against benefits when it comes to prostate cancer screening with PSA testing. Consensus on the best approach for population-based prostate cancer screening and early detection has not yet been reached. And the World Health Organization has not yet developed specific recommendations for prostate cancer screening, although guidance has been developed on the health system requirements for cancer screening and early detection programs in general.
The meeting offered an opportunity to reinforce that prostate cancer screening, like other similar cancer screening efforts, requires education and counseling, so patients are well-informed about the harms and benefits and take decisions about their own health; requires access to services and application of evidence based guidelines that health care workers are trained in using; and referral mechanisms and access to prompt diagnosis and treatment, with counseling on the side effects associate with treatment.
Presentations:
- The burden of prostate cancer in the region, in the context of the Global Burden of Disease Project. Héctor Lamadrid, National Institute of Public Health of Mexico
- The role of prostate specific antigen (PSA) testing in screening and early detection of prostate cancer. Matthew Cooperberg, University of California, San Francisco
- U.S. Preventive Services Task Force: Draft Prostate Cancer Screening Recommendation. Alex Krist, US Preventive Services Task Force
- Experiences in implementing Canada's prostate cancer screening guidelines. James Dickinson, Canadian Task Force on Preventive Health Care