In 2007, the deaths of 2,938 Australian men were attributed to prostate cancer. It is the second-biggest cancer killer of Australian men after lung cancer.
Prostate cancer death increases with age at a markedly higher rate than other cancers. For example, although prostate cancer caused 747 more deaths in Australian men than bowel cancer in 2007, twice as many men aged under 70 died from bowel cancer than from prostate cancer (871, compared with 440) and four times as many men under 60 died from bowel cancer than from prostate cancer (361 compared with 83).
In 2009, 19,438 Australian men were diagnosed with prostate cancer. The ratio of incidence to mortality (new cases per year divided by deaths per year) is much higher for prostate cancer than for most cancers.
The causes of prostate cancer are poorly understood and there are no accepted prevention methods. Major risk factors for prostate cancer include age and family history.
The overall benefits of screening for prostate cancer using the prostate specific antigen (PSA) test, with or without digital rectal examination, are currently uncertain and there is no organised population screening program for prostate cancer in Australia or anywhere in the world. However, individual men may ask their doctors for prostate cancer screening and doctors may recommend it. Screening using the PSA test is common.
The screening of apparently healthy men using the PSA test is a complex and controversial issue and the subject of ongoing debate, both in Australia and internationally.
While some prostate cancers are aggressive and life-threatening, many grow slowly and do not progress sufficiently during life to cause any problems. No current test, including the PSA test, can adequately distinguish between these two kinds of prostate cancer. Consequently, while screening of apparently healthy men may offer a longer life to those with aggressive cancers, it may harm men with indolent cancers by exposing them to treatments that cause significant side effects such as urinary incontinence and impotence, without any compensating benefit.
Debate centres on the balance of benefits and harms that may arise from screening for prostate cancer using PSA testing.
While the uncertainty persists, Cancer Council Australia does not recommend organised population screening for prostate cancer in Australian men. Individual men who ask for, or are offered screening are advised to make an informed decision about whether or not to be screened.