Routine testing for prostate cancer may be harmful

Routine testing for prostate cancer is not recommended for most men as it has uncertain benefits and clear harms, according to an international panel of experts.

However, for some men, such as those with a family history of prostate cancer, discussions about possible harms and benefits of regular screening with their doctor is essential, they said. A panel of international experts including those from University of Helsinki in Finland and McMaster University in Canada based their advice on the latest scientific evidence as a part of The BMJ journal’s ‘Rapid Recommendations’ initiative — to produce trustworthy guidance based on new evidence to help doctors make better decisions with their patients.

The prostate specific antigen (PSA) test is the only widely used test currently available to screen for prostate cancer. It is used in many countries, but remains controversial because it has increased the number of healthy men diagnosed with and treated unnecessarily for harmless tumours.

The research found that if screening reduces prostate cancer deaths at all, the effect is very small. The panel advises against offering routine PSA screening and says most men will decline screening because of the small and uncertain benefits and the clear harms.

However, men at higher risk of prostate cancer death — for example, those with a family history of prostate cancer or of African descent — may be more likely to choose PSA screening after discussion of potential benefits and harms of testing with their doctor, researchers said.

Women who experience sexual assault have vivid memories of the incident for decades, even if they are not diagnosed with post-traumatic stress disorder, a study has found. Unlike women coping with the aftermath of other traumatic, life-altering events, victims of sexual violence had more intense memories that were difficult, if not impossible, to forget. “To some extent it is not surprising that these memories relate to more feelings of depression and anxiety because these women remember what happened and think about it a lot,” said Tracey Shors, a professor at Rutgers University in the US.

“But these feelings and thoughts are usually associated with PTSD and most women in our study who experienced these vivid memories did not suffer from PTSD, which is generally associated with more intense mental and physical reactions,” said Shors, who co-authored the study published in the journal Frontiers in Neuroscience. The study included 183 college-aged women between the ages of 18-39. Sixty-four women reported that they were victims of sexual violence while 119 did not have a history of sexual violence.

Less than 10 per cent were on anti-anxiety or antidepressant medication. The women with a history of sexual violence reported stronger memories with specific details that included seeing the event clearly in their mind. They reported having a harder time forgetting the incident and believed it to be a significant part of their life story. “Each time you reflect on an old memory, you make a new one in your brain because it is retrieved in the present space and time,’’ said Shors.