Professor Hein Van Poppel warns of risks of ‘opportunistic’ screening for prostate cancer

There is an urgent need to differentiate between “organised” screening and “unorganised” or “opportunistic” screening when advocating for early detection programmes for prostate cancer, Hein Van Poppel told delegates to the Europa Uomo General Assembly and Masterclass.

Professor Van Poppel, Chair of the European Association of Urology Policy Office and a long-time campaigner for prostate screening programmes, explained the importance of programmes being organised and based on men’s risk level. Only men of a given age and risk category should be invited for screening – and by an organisation or institution. This will reduce the risk of identifying harmless prostate cancers and subsequent overtreatment.

“Do not make healthy men patients,” he said. “Men should be invited for a PSA test by an organisation, which then tells them to come back in two years, or five years, or go to see a urologist.”

“It’s very important that this is not impacting on the health care system, that it does not overwork general practitioners or urologists,” said Professor Van Poppel.  “We must avoid overdiagnosis and overtreatment. We need to decrease the number of unnecessary examinations.”

He pointed out that opportunistic screening is all too common today – which is why the pan-European PRAISE-U project investigating effective means of organised screening is so important.

“In Denmark and Poland opportunistic screening is very heavy,” he said. “In low-income countries like Kosovo, a man when he is 50 can have every year a test reimbursed by the state. That is opportunistic screening. And it doesn’t work. It has no effect on population prostate cancer mortality. On the other hand, it does not avoid overdiagnosis and overtreatment.”

In other presentations during the Europa Uomo Masterclass, advances in surgery, radiotherapy, radionucleotide therapy and targeted drugs were addressed by Finnish specialists Teemu Murtola, Timo Joensuu, Leila Vaalavirta and Tommi Kilpeläinen.