Scientists have argued that public health news surrounding prostate cancer could hamper early detection efforts by giving a misleading focus on urinary symptoms.
Cambridge University researchers say there is “no evidence of a causal relationship between prostate cancer and either prostate size or troublesome male urinary symptoms”.
However, many public health guidelines encourage this link – with an increased need to urinate at the top of the list of prostate cancer symptoms listed on the NHS website.
In a review published in the journal BMC Medicine, the Cambridge researchers argue that the “strong public perception” that male urinary tract symptoms are a key predictor of prostate cancer “could seriously hamper efforts to encourage early presentation.”
“If the rate of earlier diagnosis is to improve, we want a clear message that prostate cancer is a silent disease, especially in the curable stages, and men should come forward for testing regardless of whether they have symptoms or not,” it said in the paper.
“This should be done in parallel with other ongoing awareness-raising efforts, including targeting men at highest risk based on race or family history.”
Prostate cancer is the most common type of cancer in men.
According to Cancer Research UK, more than 52,000 men are diagnosed with prostate cancer each year and there are more than 12,000 deaths.
More than three quarters (78%) of men diagnosed with the disease survive beyond 10 years, but this proportion has changed little in the UK over the past decade, largely because the disease was detected at a relatively late stage becomes.
In England, for example, almost half of all prostate cancers are diagnosed at stage three in four (stage four being the final stage).
Vincent Gnanapragasam, Professor of Urology at Cambridge University, said: “When most people think of the symptoms of prostate cancer, they think of problems with urination or needing to pee more often, especially at night.
“This misperception has persisted for decades despite very little evidence, potentially preventing us from picking up cases at an early stage.”
Enlarged prostate can cause the urinary tract problems that are often cited in public health news, but evidence suggests these are rarely due to malignant prostate tumors, according to the researchers.
Rather, research suggests that the prostate is smaller in prostate cancer.
“We urgently need to recognize that the information that is currently being given to the public can give men a false sense of security when they do not have urinary symptoms,” Professor Gnanapragasam said.
“We must emphasize that prostate cancer can be a silent or asymptomatic disease, especially in its curable stages.
“Waiting for urinary symptoms can mean you miss opportunities to contract the disease when it’s treatable.
“Men shouldn’t be afraid to talk to their GP about testing and the value of a PSA test, especially if they have a family history of prostate cancer or other risk factors, such as a history of prostate cancer. E.g. black or mixed race ethnicity.”