Men with early, curable stages of prostate cancer are missing opportunities to have their cancer detected because national guidelines and media health campaigns focus on urinary symptoms despite a lack of scientific evidence, say experts at the University of Cambridge.

Prostate cancer is the most common type of cancer in men. According to Cancer Research UK, over 52,000 men are diagnosed with prostate cancer each year and there are more than 12,000 deaths.

Over three-quarters (78%) of men diagnosed with the disease survive for over ten years, but this proportion has barely changed over the past decade in the UK, largely because the disease is detected at a relatively late stage. In England, for example, nearly half of all prostate cancers are picked up at stage three of four (stage four being the latest stage).

Despite no evidence of a link between urinary symptoms and prostate cancer, national guidelines, health advice and public health campaigns continue to promote this link. In a review published today in BMC Medicine, Cambridge researchers argue that not only is this unhelpful, but it may even deter men from coming forward for early testing and detection of a potentially treatable cancer.

“When most people think of the symptoms of prostate cancer, they think of problems with peeing or needing to pee more frequently, particularly during the night,” said Vincent Gnanapragasam, Professor of Urology at the University of Cambridge and an Honorary Consultant Urologist at Addenbrooke’s Hospital, Cambridge. “This misperception has lasted for decades, despite very little evidence, and it’s potentially preventing us picking up cases at an early stage.”

Prostate enlargement can cause the urinary problems often included in public health messaging, but evidence suggests that this is rarely due to malignant prostate tumours. Rather, research suggests that the prostate is smaller in cases of prostate cancer. A recent study — the UK PROTECT trial — even went as far as to say that a lack of urinary symptoms may in fact be an indicator of a higher likelihood of cancer.

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