Whereas one in eight men in British Columbia will be diagnosed with prostate cancer in their lifetime representing the number one cancer risk to men; And whereas the economic, family and social costs to our province would be significantly diminished through increased awareness and early detection: Therefore be it resolved that UBCM request the provincial government make prostate-specific antigen PSA testing free for all men in the province to ensure that all men have the opportunity to have prostate cancer diagnosed as early as possible so that survival and quality of life will be improved; And be it further resolved that UBCM and its constituent members declare September to be Prostate Cancer Awareness Month.
Ministry of Health Prostate Specific Antigen PSA testing is publicly insured for men who meet specific criteria including monitoring of established disease, detection of early reoccurrence of disease, or those suspected of having prostate cancer due to signs or symptoms of disease. In 201516, there were 260,126 publicly insured PSA tests performed in BC at a cost of approximately 3 million. The use of PSA testing as a population-wide screening tool is not currently supported in British Columbia. Clinical evidence indicates that PSA screening yields a high rate of false-positive results which can lead to subsequent evaluation, testing and therapy, over-diagnosis and treatment. A biopsy is the only way to confirm prostate cancer. Potential harms associated with biopsy include: bleeding, pain, fever, urine retention, and infection including prostatitis and urosepsis. Seventy-six percent of prostate biopsies performed after an elevated PSA in the European Randomized Study of Screening for Prostate Cancer, resulted in no cancer being detected. The standard method in British Columbia for early detection of prostate cancer is the digital rectal examination which should be performed annually in fit men 50-70 years of age or at any age when obstructive or other urinary tract symptoms are present. Digital rectal examinations are publicly insured. The Ministry employs rigorous criteria for the adoption of new population-based screening programs, including assessing clinical effectiveness, population health impact, and cost effectiveness. The Ministry continues to monitor emerging scientific and clinical evidence that may merit consideration of a screening program that utilizes PSA testing in the future. Three key bodies have all recommended against population-based PSA testingthe US Preventive Task Force, the Canadian Preventive Task Force and the BC Cancer Agencys Genito-urinary Tumour Group. Research shows over-diagnosis and overtreatment from population-based screening may actually result in poorer quality of life for men if PSA testing is used in the general population.