• Login
    View Item 
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    •   Home
    • The Christie Research Publications Repository
    • All Christie Publications
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of ChristieCommunitiesTitleAuthorsIssue DateSubmit DateSubjectsThis CollectionTitleAuthorsIssue DateSubmit DateSubjects

    My Account

    LoginRegister

    Local Links

    The Christie WebsiteChristie Library and Knowledge Service

    Statistics

    Display statistics

    Urinary symptoms and prostate cancer-the misconception that may be preventing earlier presentation and better survival outcomes

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    35922801.pdf
    Size:
    852.4Kb
    Format:
    PDF
    Description:
    Identified with Open Access button
    Download
    Authors
    Gnanapragasam, V. J.
    Greenberg, D.
    Burnet, Neil G
    Affiliation
    Department of Urology, Cambridge University Hospitals Trust, Cambridge, UK
    Issue Date
    2022
    
    Metadata
    Show full item record
    Abstract
    Background: Prostate cancer is an epidemic of the modern age, and despite efforts to improve awareness, it remains the case that mortality has hardly altered over the decades, driven largely by late presentation. There is a strong public perception that male urinary symptoms is one of the key indicators of prostate cancer, and this continues to be part of messaging from national guidelines and media health campaigns. This narrative, however, is not based on evidence and may be seriously hampering efforts to encourage early presentation. Discussion: Anatomically, prostate cancer most often arises in the peripheral zone, while urinary symptoms result from compression of the urethra by prostatic enlargement more centrally. Biopsy studies show that mean prostate volume is actually lower in men found to have (early) prostate cancer compared to those with benign biopsies. This inverse relationship between prostate size and the probability of cancer is so strong that PSA density (PSA corrected for prostate volume) is known to be significantly more accurate in predicting a positive biopsy than PSA alone. Thus, this disconnect between scientific evidence and the current perception is very striking. There is also evidence that using symptoms for investigating possible cancer may lead to higher proportions of men presenting with locally advanced or metastatic disease compared to PSA testing or screening programmes. Concerns about overwhelming health care services if men are encouraged to get tested without symptoms may also be overstated, with recent newer approaches to reduce over-investigation and treatment. In this article, we explore the link between urinary symptoms and prostate cancer and propose that public and professional messaging needs to change. Conclusion: If rates of earlier diagnosis are to improve, we call for strong clear messaging that prostate cancer is a silent disease especially in the curable stages and men should come forward for testing regardless of whether or not they have symptoms. This should be done in parallel with other ongoing efforts to raise awareness including targeting men at highest risk due to racial ancestry or family history. While the current resurgence in interest and debate about prostate cancer screening is timely, change of this message by guideline bodies, charities and the media can be a first simple step to improving earlier presentation and hence cures rates.
    Citation
    Gnanapragasam VJ, Greenberg D, Burnet N. Urinary symptoms and prostate cancer-the misconception that may be preventing earlier presentation and better survival outcomes. BMC medicine. 2022 Aug 4;20(1):264. PubMed PMID: 35922801. Pubmed Central PMCID: PMC9351095. Epub 2022/08/04. eng.
    Journal
    BMC Medicine
    URI
    http://hdl.handle.net/10541/625547
    DOI
    10.1186/s12916-022-02453-7
    PubMed ID
    35922801
    Additional Links
    https://dx.doi.org/10.1186/s12916-022-02453-7
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1186/s12916-022-02453-7
    Scopus Count
    Collections
    All Christie Publications

    entitlement

    Related articles

    • PSA testing for men at average risk of prostate cancer.
    • Authors: Armstrong BK, Barry MJ, Frydenberg M, Gardiner RA, Haines I, Carter SM
    • Issue date: 2017 Jul 26
    • Prostate cancer screening practices in a large, integrated health system: 2007-2014.
    • Authors: Misra-Hebert AD, Hu B, Klein EA, Stephenson A, Taksler GB, Kattan MW, Rothberg MB
    • Issue date: 2017 Aug
    • The absence of voiding symptoms in men with a prostate-specific antigen (PSA) concentration of ≥3.0 ng/mL is an independent risk factor for prostate cancer: results from the Gothenburg Randomized Screening Trial.
    • Authors: Frånlund M, Carlsson S, Stranne J, Aus G, Hugosson J
    • Issue date: 2012 Sep
    • Five-year downstream outcomes following prostate-specific antigen screening in older men.
    • Authors: Walter LC, Fung KZ, Kirby KA, Shi Y, Espaldon R, O'Brien S, Freedland SJ, Powell AA, Hoffman RM
    • Issue date: 2013 May 27
    • Prostate specific antigen density of the transition zone for early detection of prostate cancer.
    • Authors: Djavan B, Zlotta AR, Byttebier G, Shariat S, Omar M, Schulman CC, Marberger M
    • Issue date: 1998 Aug
    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Quick Guide | Contact Us
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.