If the EU is sincere about beating cancer, then it needs to extend the scope of Europe’s Beating Cancer Plan to include prostate cancer and the use of Prostate Specific Antigen (PSA) screening tests to boost early detection.
There are more than two million men in the EU currently living with prostate cancer, and every year it claims the lives of 110,000 of them. These men have friends and family and people; we owe it to them to be effective in dealing with prostate cancer and in boosting early detection measures.
I have been working with the Hellenic Urological Association on this matter, and earlier this year I submitted a written question to the European Commission regarding the early detection of prostate cancer.
In it, I urged the EU Executive to extend targeted cancer screening beyond breast, colorectal and cervical cancer and to include prostate cancer in the scope of Europe’s Beating Cancer Plan.
Screening for prostate cancer, by definition, implies the systematic examination of men without symptoms who are, however, at risk of developing the prostatic malignant neoplasm. The purpose of screening is twofold: first, to reduce mortality rates due to prostate cancer and second, to maintain a high quality of life for prostate cancer patients.
Recent technological advances, and the use of PSA screening tests, have led to the prevention of more than 14 percent of prostate cancer related deaths.
“Earlier this year I submitted a written question to the European Commission regarding the early detection of prostate cancer. In it, I urged the EU Executive to extend targeted cancer screening beyond breast, colorectal and cervical cancer and to include prostate cancer in the scope of Europe’s Beating Cancer Plan”
It is true that initial mass screening did in fact lead to an overdiagnosis of prostate cancer, which led many men to undergo therapeutic procedures for indolent cancer. Following an anti-PSA-based screening recommendation in 2012 in the US, there has been a mass reduction in its use for early detection across the globe.
However, since the reduction in the use of PSA screening, there has been a decrease in prostate cancer diagnoses. The lack of PSA screening has had unfortunate consequences, as the number of cases diagnosed at an advanced stage has been notably higher.
In the UK alone, prostate cancer deaths have increased by 17 percent in 10 years and have a higher mortality rate than breast cancer. In Germany, prostate cancer is now the second-highest cause of death among men.
Currently, widescale prostate cancer screening occurs in an opportunistic setting, with rates varying by region and socioeconomic status. This opportunistic screening has proven ineffective, with no mortality reduction but considerable overdiagnosis.
For quite some time now, PSA screening has proven to be effective in reducing prostate cancer mortality at the cost of overdiagnosis. It is also more effective than opportunistic screening and therefore better for maintaining patient quality of life.
There are risk-adapted and personalised strategies on the natural course of prostate cancer in different risk groups. This, along with the role of MRI, allows us to reduce the pitfalls associated with mass screening.
We can, therefore, establish a favourable benefit/risk balance of early detection while at the same time maintaining a reduction in metastases and mortality rates. The European Association of Urology has defined key age ranges and established guidelines for further actions following initial PSA screening and incorporated them into a new algorithm for early detection of prostate cancer that balances these benefits and risks.
“The EU needs to recognise the progress that PSA screening has made in recent years in incorporating new technology and ensuring the early detection of prostate cancer”
Use of Artificial Intelligence technology has enabled PSA screenings to be improved without the need for invasive tests.
The European Parliament’s Special Committee on Beating Cancer has announced that it is planning to update the Council’s recommendation on breast, cervical and colorectal cancer screening to include prostate cancer screening programmes.
I hope that the committee utilises the new developments in cancer screening technologies, including MRI and the EUA’s algorithm, to formulate a pro-PSA screening stance. In addition, the EU4 Health Programme supports and complements EU Member States in their efforts to improve the surveillance, diagnosis and treatment of cancer and will create synergies to support funding from other EU programmes.
The EU needs to recognise the progress that PSA screening has made in recent years in incorporating new technology and ensuring the early detection of prostate cancer and reducing the number of men in the EU who die from the disease.
The EU needs to recognise the severity of prostate cancer and to extend the scope of as a result Europe’s Beating Cancer plan to include prostate cancer and the use of PSA screenings.