Prostate Cancer Screening

After lung cancer, the biggest killer among men is prostate cancer.

To date, there is insufficient knowledge as to the cause of this disease, or how to prevent it.
We asked some of our EH correspondents to report on measures taken in their countries to ensure that men are made more aware of this disease and whether screening services are provided for early prostate cancer detection.

THE CZECH REPUBLIC

Rostislav Kuklik reports:
The country uses one of the most common screening tests for prostate cancer — a combination of rectum prostate gland palpation and blood testing for the presence of prostate specific antigen (PSA). Although some health insurers paid for this examination earlier, this is no longer the case. Fortunately discussions are ongoing regarding the re-establishment of the payment because the examination does not exceed 150-200 CZK (about 5-7 euros) — an insignificant sum compared with the consequences of the undiagnosed illness. In any case, it is an investment that really pays off in the end. In particular, men in whose families prostate cancer previously occurred should not hesitate too long before screening.
Czechs appear to be generally afraid to pursue all the options they have for cancer screening. Such an attitude is rather short-sighted, because a cancer detected in its infancy can be successfully treated. Professor Zdenek Dienstbier, President of the League against Cancer in Prague, recently reported, for example, that although breast and colon cancer screenings are fully paid from common health insurance plans, and breast screening is well organized, ‘Patients’ awareness and interest in it are rather dissatisfying; roughly half of women completely ignore the cancer screening possibilities. And, unfortunately, the numbers for colon and rectum cancer are even worse — we are talking about only 20 -30% of the population being voluntarily tested.’
Country-wide full-scale screening of cervical cancer for women, launched last year, is slowly taking off. However, just as every woman should have a gynaecologist, every man in his 50s should have an urologist for examinations, yet there is no similar screening for prostate cancer in the Czech Republic.
Cancer is the second most common cause of death in the Czech Republic after cardiovascular diseases. Every year, cancer affects 69,000 people, ending in death for 29,000. Screening contributed to increased numbers of tumours revealed in early stages, enabling a higher percentage of survivals. If people visited their doctors for regular screenings, cancer mortality rates in this country would decrease significantly – as already shown in breast cancer, where cases were growing but mortality rates were either stagnating or even slowly declining. The greatest obstacle for participation in screenings is the fact that people are afraid of a cancer diagnosis, thought by most to be a death sentence. ‘But it’s exactly the other way round,’ said Prof Dienstbier. ‘If I suspect anything, I should pay doctor a visit as soon as possible, because I’d have a greater chance of cure.’
So much is up to individuals: leading a healthy life and striking a balance between work and family, thus reducing stress, and if in the slightest doubt about health, getting rid of unnecessary fears, and making an appointment with the doctor. Czech health insurance companies pay for preventive examinations once every two years. There is no reason to squander that opportunity.

01.03.2009

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