Description
Prostate cancer starts in the prostate gland, which is part of the male reproductive system. It is the size of a walnut and surrounds the urethra just below the bladder.
Prostate cancer tends to develop slowly. Although most men with prostate cancer die of causes unrelated to their prostate cancer, prostate cancer is the second leading cause of cancer death among men.
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Minimizing the Risks
Insufficient evidence exists over whether the benefits of screening for prostate cancer outweigh the risks and costs involved. The prostate specific antigen test (PSA) together with the digital rectal exam (DRE), has been associated with the detection of early-stage, treatable cancers. However, there is no conclusive evidence that screening of asymptomatic men reduces mortality from the disease. At the same time, early diagnosis and treatment of cancers which in many cases may not significantly progress during the patient's lifetime can cause morbidity (e.g. impotence, urinary incontinence) leading to diminished quality of life. Results from two international randomized trials assessing the effectiveness of PSA screening anticipated in 2006 and 2008, should help clarify the uncertain benefits and risks of PSA screening.
Men at low-risk for prostate cancer, beginning at age 50 and older, should discuss the benefits and risks of early detection using prostate specific antigen (PSA) testing and digital rectal examination (DRE) with their doctor.
Men at high-risk of prostate cancer, such as men of African ancestry, and those with a strong family history of prostate cancer may wish to discuss the need for testing at a younger age.
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Facts and Figures
Prostate cancer is the most commonly diagnosed cancer among Canadian men, excluding non-melanoma skin cancer. In 2003, an estimated 18,800 men in Canada will be diagnosed with prostate cancer and 4,200 will die of the disease. Prostate cancer incidence increases almost exponentially with age; most cases are diagnosed in men aged 65 years or older.
Prostate cancer incidence increased gradually for the period 1982-1989, increased rapidly until peaking in 1993, fell until 1995, and has been slowly increasing since. The large increases in the early 1990's reflect the adoption of PSA screening.
Prostate cancer mortality rates have fallen by 14% since 1995.
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How the Government of Canada is taking action
The considerable economic and societal burden of prostate cancer and its treatment, coupled with the projected large increase in the number of new prostate cancer cases as the population ages, make this disease a very important public health issue. In 1999, Health Canada allocated $15 million over five years for prostate cancer research to the Vancouver Centre of Excellence for Prostate Cancer Research and the National Cancer Institute of Canada.
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Strategies, Programs and Projects
Canadian Cancer Control Strategy:
Beginning in 1999, Health Canada has been working in partnership with the Canadian Cancer Society / National Cancer Institute of Canada and the Canadian Association of Provincial Cancer Agencies to develop the Canadian Strategy for Cancer Control (CSCC). Extensive consultations resulted in six areas for priority action: Standards, Guidelines, Prevention, Rebalance Focus, Human Resources and Strategic Research.
The strategy aims to optimize the benefits of current knowledge and available resources for cancer control while enhancing the sustainability of the health care system through more collaborative planning, priority setting, and public policy development. Implementation of the strategy will help reduce the incidence, morbidity and mortality of cancer, and enhance the quality of life of those living with cancer.
A Governing Council that includes Health Canada, National Government Organizations, Provincial Cancer Agencies or ministries and public representation has been established, and action groups have been set up in the priority areas. The Secretariat for the Strategy is housed within the Centre for Chronic Disease Prevention and Control at Health Canada.
For more information visit www.cancercontrol.org or contact the CSCC Secretariat Office at info@cancercontrol.org.
Canadian Cancer Surveillance Alliance
Surveillance is a key contributor to effective disease control and is the motivating force behind the Canadian Cancer Surveillance Alliance (CCSA) (formerly known as the Canadian Coalition for Cancer Surveillance) which facilitates and coordinates partnerships and projects designed to enhance Canada's system of cancer surveillance. Members of the alliance include: Canadian Association of Provincial Cancer Agencies, Centre for Chronic Disease Prevention and Control, Centre for Surveillance Coordination, Health Canada. Statistics Canada, National Cancer Institute of Canada, Canadian Cancer Society, Canadian Council of Cancer Registries, Institute for Cancer Research, Canadian Society for Epidemiology and Biostatistics, Canadian Oncology Society, Canadian Institute for Health Information.
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