Regional Experts Discuss Approaches for Prostate Cancer Screening and Early Detection in the Americas

Cancer control and public health experts met to review the evidence and experiences on prostate cancer screening in the Americas, on September 12 and 13, 2017, in Mexico City, Mexico. The meeting was convened by the Pan American Health Organization/World Health Organization (PAHO/WHO), in collaboration with the Mexico National Institute of Cancer and Mexico National Institute of Public Health.

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.