Should I, as a man, be tested for prostate cancer with the PSA test?
Whether the PSA test is worthwhile depends on your personal risk. Men aged 55 to 69 with an elevated risk, such as a family history or Black background, have the most reason to discuss this with their GP.
The PSA test reduces the chance of dying from prostate cancer, but the effect is modest. In a large European study, the screened group died from prostate cancer 13% less often after 23 years. In absolute numbers: for every 456 men invited for screening, one death was prevented. On the chance of dying from any cause combined, screening has no demonstrable effect.
Set against that is a serious drawback: overdiagnosis. Screening produces 30% more prostate cancer diagnoses. A large proportion of these are slow-growing tumours that would probably never have caused any trouble without screening. Yet those diagnoses often lead to treatment, and treatments have side effects. Per 1,000 men screened, estimates suggest: 1 extra hospital admission due to blood poisoning after a biopsy (tissue sample), 3 extra men with urinary leakage, and 25 extra men with erection problems. These are modelled estimates, not directly measured figures.
Whether screening is worthwhile for you depends on your risk profile. Black men develop prostate cancer almost twice as often as white men. Having a father or brother with prostate cancer also raises your risk considerably. For men with such an elevated risk, the balance may tip more readily towards screening.
Guidelines advise men aged 55 to 69 to make this decision together with their GP. That conversation covers your age, family history and background, but also how much weight you place on the chance of overdiagnosis and side effects versus the chance of a death being prevented. There is no universally right answer. Men over 70 are generally no longer routinely invited for screening, because the benefit diminishes further by that point.
Based on two large studies: one European study with 23 years of follow-up and one British study with 15 years of follow-up. Also based on many studies combined and guideline sources. The side-effect estimates are modelled figures. The two studies together cover hundreds of thousands of men.
Should you get tested for hereditary breast cancer?
Breast cancer can be hereditary, and if you recognise multiple cases in your family, it is sensible to discuss this with your GP or a genetic counsellor to decide whether testing makes sense for you.
Is breast cancer screening worth it?
Participating in breast cancer screening may offer a small benefit, but the chance of unnecessary treatment or a false-positive result is real. Consider what matters most to you, and discuss it with your GP if you are unsure.
Is it true that circumcision protects against penile cancer and HPV?
Circumcision early in life is associated with a clearly lower risk of invasive penile cancer and a reduced likelihood of carrying HPV, but part of that protection operates through the prevention of phimosis. HPV vaccination is a better-supported prevention step for most people.
Do lycopene and tomatoes protect against prostate cancer?
Processed tomato products are linked to a lower risk of prostate cancer, but whether lycopene is the cause is not certain. Lycopene supplements offer no proven benefit; simply eating more tomato sauce is the best-supported choice.
Does being overweight increase my risk of cancer, and if so, which types?
Excess weight increases your risk of at least 13 types of cancer, including uterine, colorectal, breast and liver cancer. Losing weight reduces that risk, although it remains unclear whether all methods of weight loss are equally effective for immune defence against cancer.
Does using the contraceptive pill increase my risk of cancer?
The pill demonstrably lowers the risk of ovarian and uterine cancer, but slightly raises the risk of breast cancer with long-term use or use before a first pregnancy. Discuss your personal situation with your GP or gynaecologist if you have any doubts.