Prostate cancer

Both resources can be downloaded from the NZ Guidelines Group website.

Testing for prostate cancer: A consultation resource

This is a consultation resource for primary care practitioners asked about prostate cancer testing.

• Testing for Prostate Cancer: A Consultation Resource

Testing for Prostate Cancer: Information for Men and their Families

A pamphlet to help men decide if they should be tested for prostate cancer.

• Testing for Prostate Cancer: Information for Men and their Families

Update on these resources

The Government response to the Health Committee’s Inquiry into the early detection and treatment of prostate cancer was presented to the House on 13 October 2011. Overall, the Government supports the Health Committee’s recommendations and has tasked the Ministry of Health with leading the development of evidence-based resources for men and their general practitioners. In doing so, the Ministry will ensure the resources are meaningful, useful, accessible to people with lower levels of health literacy and available from a wide range of sources, including from general practice.  

The Ministry is therefore not reprinting in hard copy the testing for prostate cancer resources on this page.  However, as they contain some useful information, they can be downloaded as PDF files in the interim.

The questions and answers below were developed to support the original publication of the resources.

Questions and answers

On this page:

1. Why were these resources developed now?
2. How serious is prostate cancer for men?
3. If it such a serious problem why is there no screening programme?
4. Some urologists say that all men should be actively encouraged to be tested even if they do not have any symptoms.
5. What type of tests are there and where can I get one?
6. Can a man still ask for a test?
7. Is the decision not to have a screening programme a budget issue?
8. Should a prostate check be part of an annual health check for men?
9. How many men die from prostate cancer every year?
10. How many men have a PSA test now?
11. What’s different in these resources from the 2004 version and why?
12. Who was involved in developing these guidelines?
13. Why did it take four years to update the old guidelines?

1. Why were these resources developed now?

The Ministry of Health is responsible for ensuring that all its guidance and resources are as up-to-date as possible. The prostate cancer resources were last updated in 2004. The resources have taken two years to complete and are based on current evidence. When and if this changes the resources will be updated again. During this time, PSA testing, follow-up investigations and treatment, if required, have continued to be publicly funded and will continue to be so.

2. How serious is prostate cancer for men?

Prostate cancer is a complex health issue and can have serious consequences if it is not treated.

It is the third most common cause of death from cancer for men (after lung and bowel cancer) and the chances of being diagnosed with prostate cancer increases every decade after the age of 50.

Most men with prostate problems do not have prostate cancer, however they have the right to know about what can be done and treatment options if they are concerned about prostate cancer. The resource for men and their families provides that information.

3. If it such a serious problem why is there no screening programme?

There is no currently no evidence that shows a population based screening programme for men with no symptoms of prostate cancer would improve outcomes for men, however men who are concerned can be tested if they choose to.

4. Some urologists say that all men should be actively encouraged to be tested even if they do not have any symptoms

Prostate cancer is an important men’s health issue and preventing deaths from prostate cancer is a high priority. However, there is no conclusive international evidence that screening for prostate cancer saves lives, nor whether the potential benefits of this testing outweighs the associated risks.

Current international best practice is not to have a screening programme for prostate cancer. The British Association of Urological Surgeons states “Prostate cancer screening cannot be justified on current evidence. PSA testing should only be performed after full counselling. There is no evidence to support opportunistic screening”.

There are different views even among urologists, and most urology professional bodies are clear that the evidence is still insufficient to actively encourage men to be tested.

5. What type of tests are there and where can I get one?

A PSA test (blood test to measure the level of Prostate Specific Antigen in your blood) and digital rectal examinations are available through your doctor.

A TRUS (prostate) biopsy is necessary to make a diagnosis of prostate cancer and provides information about the type of cancer (if any) present.

6. Can a man still ask for a test?

Yes – and this has been the case since PSA testing became available. This has not changed.

7. Is the decision not to have a screening programme a budget issue?

No. At this stage evidence clearly shows that there is no requirement for a national screening programme.

8. Should a prostate check be part of an annual health check for men?

Prostate cancer is rare in men below the age of 50. It is important men understand how the prostate gland works and the symptoms of prostate problems.

The decision to have an annual check up for prostate cancer is an individual choice however if a man notices any changes or problems with their urinary function they should consult their doctor.

9. How many men die from prostate cancer every year?

About 14% of male cancer deaths (4% of all deaths) are from prostate cancer, with two-thirds of these deaths occurring in men over 75 years of age.

10. How many men have a PSA test now?

An estimated 33 percent of men over 50 years of age had a PSA test in 2007, and 54 percent over 50 years had a test at some stage over the three-year period from 2005 to 2007. The age groups most likely to have a PSA test were those between 65 and 74 years. Approximately forty percent of men in this age group have had a test over a one-year period and approximately sixty percent of men in this age group have had a test over a three year period.

11. What’s different in these resources from the 2004 version and why?

There are now two resources available where previously there was only one. Just as importantly these are based on current evidence.

The first resource is for men and their families and provides details on the function of the prostate gland, identifies prostate problems and advises on the different tests and treatments available.

The second guideline is a consultation resource for doctors who are asked about prostate cancer testing.

12.Who was involved in developing these guidelines?

The Ministry of Health, New Zealand Guidelines group, Cancer Society, Prostate Cancer Foundation and the Royal College of GPs.

13. Why did it take four years to update the old guidelines?

The previous resources were published in late 2004. They stood for around two years before it was decided they needed to be reviewed and updated. This is not a long time in terms of medical advice.

The process of reviewing and updating them began in 2006. Researching and reviewing international and national evidence takes time. It was imperative that all the available evidence was carefully reviewed before we committed to presenting it as advice for the public.