The comeback of early detection testing for prostate cancer: for the first time since 2008, the Association of Urologists recommends that all men in Israel aged 55-69 be tested for prostate cancer, this against the background of the beginning of International Prostate Cancer Awareness Month.
However, the Association of Family Physicians - which published new guidelines for early detection tests just last month - does not recommend the test.
The Association of Urologists recommends that men aged 55-69 (whose life expectancy is ten years or more) perform a blood test to detect the PSA protein and a rectal examination "while providing an explanation about the advantages and disadvantages of the approach".
In 2008, the Ministry of Health issued a directive to cancel PSA tests, a simple blood test that helps detect prostate cancer, which were common until then.
This is because the test results were inconclusive, and in many cases led to unnecessary tests, unnecessary treatments and unnecessary follow-up.
However, the abandonment of tests for early detection caused an increase over the years in advanced morbidity and mortality.
Now the Association of Urologists publishes its recommendations, which call for men to be tested by a simple blood test (PSA) or by rectal examination, thus diagnosing the disease in its early stages.
Necessary or unnecessary?
"At the core of the guidelines is a dramatic change in the diagnosis of prostate cancer and in the understanding of the disease," explains Dr. Shay Golan, director of the uro-oncology service at Bilinson and the drafters of the new recommendation.
But the family doctors actually oppose the recommendation.
Last month, the "Israeli Task Force" published up-to-date and comprehensive recommendations in all areas of health that were prepared for family doctors.
There, the recommendations are only to discuss with the treating doctors if a PSA test is necessary, and even include a warning that "the test overdiagnoses patients, and as a result invasive tests are performed, and even treatment of tumors that would not develop into metastatic cancer, as well as the side effects of the surgeries."
Professor Lahad, photo: Yehoshua Yosef
Prof. Amnon Lahad, one of the authors of the recommendations and a senior member of the Association of Family Physicians, notes: "The Association of Urologists does not coordinate with us. A rectal examination has been proven to be of no use in preventing future complications. Regarding the PSA test, it is one of the tests that lead to overdiagnosis. There is more than one opinion in the medical world. When a professional doctor gives a recommendation, he sees the difficult cases, while the family doctor sees the mild cases and the healthy ones."
Itzi Baer, chairman of the "Living with Prostate Cancer" association: I call on all men in the risk populations to be tested, in accordance with the recommendations, through a simple blood test, thereby helping to detect the disease in time and treat it accordingly."
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