A National Health Committee's report suggesting men should be encouraged to seek up-to-date information from their general practitioners about prostate cancer screening and treatment has been praised as well as criticised.
The report on the inquiry into early detection and treatment of the disease released yesterday does not recommend a national screening programme at this stage.
Prostate Cancer Foundation chief executive Keith Beck said the report was a "vital first step in a critical aspect of men's health".
The foundation expected general practitioners to take a lead from the report and encourage their male patients to have regular tests for prostate cancer when they reached their 40s.
Doctors would also counsel men about the benefits and limitations of such testing.
However, University of Otago epidemiologist Associate Prof Brian Cox said, after spending 18 months on hearings, the select committee had not got "any further" with the controversial issue - "confusion continues to reign".
"If the medical professionals as a group can't decide what's best, how do they expect men to?"
It was an "interesting precedent" having the National Health Committee write a guide for the medical practice of public health, he said.
Health Committee chairman Dr Paul Hutchison said the committee's findings would reduce confusion.
There had been much confusion when a 2004 committee had advised it did not recommend screening men without symptoms for prostate cancer regardless of age because of the risks associated with screening using the unreliable prostate-specific antigen test (PSA), and the effects of subsequent treatment exceeded any benefits.
Surgeons told the committee they would regularly see men with advanced prostate cancer who were frustrated and angry they had had no knowledge of, or choice to seek, a PSA test, he said.
The committee proposes GPs should be encouraged to provide men with initial consultations about the advantages and disadvantages of screening and treatment from the age of 45 during their cardiovascular risk assessment.
Doctors would be encouraged to advise men with a strong family history of the disease to have their full history noted then undergo a clinical examination, PSA testing and rectal examination from the age of 40.
If the committee's recommendations were approved by the Government, the ministry would be asked to provide, within a year, evidence-based, up-to-date and easily understood information for men about screening and treatment.
Speaking to concern about over-treatment of the disease, Dr Hutchison said in recent years there had been an increase in active surveillance where doctors would monitor patients with low-grade, slow-growing prostate cancer over time using measures such as ultrasound and PSA testing.
The report also calls for a national quality-improvement programme for prostate cancer early detection and care.
