Prostate Cancer Overdiagnosis: a New Zealand perspective

A recent study published in Australia claimed that 42% of prostate cancers diagnosed between 1982 and 2012 were actually "over diagnosed" and did not need to be treated. However, this does not reflect the current reality for men facing a prostate cancer diagnosis in New Zealand.

Such a diagnosis is a terrifying experience for an individual and although clinicians work hard to explain the reality of the situation, and the potential survival rates and the risk of complications caused by treatments, men are generally risk averse with health issues and will opt for treatment "just in case". Knowing whether the long-term risk is worth taking is a big call for men to make - it is usually easier to get treated to be sure of the better outcome.

The study is based on numbers from several decades ago (1982-2012), times when prostate cancer diagnostic procedures do not compare with the current use of improved techniques and MRI scans, significantly improving the level of accuracy in diagnosing more aggressive tumours leading to more informed treatment decisions.

While New Zealand does not have a formal screening programme for prostate cancer, there is growing evidence of the value of regular screening. Recent studies from Europe have led to the European Association of Urology producing a paper showing that screening reduces prostate-specific mortality by 21% - or one out of every 27 diagnosed. Clearly this is a good reason to develop and introduce a screening programme here.

Despite there not being a formal screening programme, research being undertaken at University of Auckland on the level of prostate testing shows high levels of testing among the appropriate age cohort of Kiwi men with over 85% having had at least one prostate check over a 10-year period.

The number of men being diagnosed with prostate cancer in New Zealand has reached an all-time high. Between 2014 - 2017 the number increased 24% to 3834, 540 more that breast cancer. While this number is alarming, the good news is that the death rate continues to fall, largely due to more men being tested, early diagnosis and improved treatments.

Prostate cancer is the number one cancer diagnosed in Kiwi men, and the third highest in deaths (over 600 each year).

The Prostate Cancer Foundation recommends that men over 50 (or over 40 where there is family history) get regular checks for prostate cancer and discuss this with their GP. The Foundation provides support to men and families going through a diagnosis and treatments and also living with the effects of their treatments.

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