A small investment in an early detection prostate cancer trial may help create massive gains for the New Zealand health system and cancer patients says Prostate Cancer Foundation president Danny Bedingfield.
“Over 700 men die of prostate cancer every year in New Zealand," says Danny.
"Current opportunistic PSA testing results in inefficient resource use and inequitable outcomes.
"While the value of PSA-based population screening is debated, the true value for New Zealand cannot be known until a pilot programme has been run and evaluated."
Prostate cancer is the most commonly diagnosed cancer, apart from skin cancers, in Kiwi men – more than 4000 men are diagnosed and over 700 die from prostate cancer every year. “Indications are that a prostate cancer early detection pilot in Waitematā and Tairāwhiti would require an investment of around $1.6 million a year, or $6.4 million over four years, but could potentially be expected to return over $100 million to the health system in cost savings and generate over half a billion in health gains for Waitematā and Tairāwhiti men over their lifetimes. “Nearly $1 million in personal income loss to working age men could also potentially be expected to be avoided." Based on modelling commissioned by the Prostate Cancer Foundation New Zealand, conducted by the New Zealand Institute of Economic Research, the plan is for a two-district pilot of a PSA-based screening programme for earlier prostate cancer detection.Focusing on Tairāwhiti and Waitematā, the pilot offers the potential to better understand both the equity dimensions of early detection and the impact of specialist nurse workforce and increased use of modern diagnostic technologies.
Danny says the final analysis will be published shortly.
“Prostate cancer is the second leading cause of cancer death in men yet there is no national early detection programme in place. “Early detection of cancer means better clinical outcomes and lives saved, as is the case with other early detection programmes. “We want to walk before we run. After a trial is completed, potentially a national early-detection scheme could be leveraged off existing infrastructure in place for breast, cervical and bowel screening programmes."Danny says they have been asking all political parties to support the implementation of a pilot scheme, which he says would be a low risk, sensible way to learn, "and then scale-up from there".
"And our indicative numbers suggest this is also a low-cost option with significant upside .
“In the meantime, while we wait for a system that can prevent men from experiencing advanced prostate cancer, whoever is the government after the election needs to move with urgency to provide treatments for men with prostate cancer that men in comparable systems overseas, like Australia, have had funded access to for years. “We have written to and been engaging with all political parties, on adopting policy to see an initial trial undertaken for early detection of prostate cancer, and further investment in medicines, diagnostic tools such as MRIs and other useful health infrastructure across the country.Danny says significant advances in technology and improved diagnostic methods mean previous risks from prostate treatment have been reduced, and the latest research clearly shows that a comprehensive early-detection programme holds the promise of halving mortality from the disease.
“There has been a lot of discussion on Men’s health. But now is the time to commit to some action if we are serious about making a difference. An investment of $1.6 million a year for a focussed trial is not a lot to ask for to save lives." Some background on early detection programmes in New Zealand: Cancer kills. Early detection of cancer reduces the number of people who die from it. Whatever the circumstance, there are always better clinical outcomes if the existence of cancer is known earlier. New Zealand agrees with this and currently takes action on some cancers. For example, every year:- Breast cancer: 3400 women are diagnosed, with 600 deaths. A comprehensive early detection programme was started in 2017.
- Colorectal cancer: 1500 women and 1700 men are diagnosed, with 1200 deaths. A comprehensive early detection programme was started in 2017.
- Cervical cancer: 160 women are diagnosed, with about 50 deaths. A comprehensive early detection programme was started in 1991.
"And because New Zealand values lives so much, we also have a significant $61 million “Road to Zero” campaign underway seeking to reduce the number of deaths on the road to zero," says Danny.
In 2022, 380 people died on New Zealand roads.
"And of course, the Government took significant measures to prevent deaths from Covid-19 from January 2020 till now, which has seen 2716 covid 19 deaths, and has a budget of circa $61 billion to prevent deaths and support the community."Over the same time period, around 2100 men died of prostate cancer. Many of these deaths will have been premature."
Danny says the Government accepts it is worthwhile to invest early to save New Zealanders’ lives, but when it comes to prostate cancer this appears to be ignored.
About the Prostate Cancer Foundation of NZ PCFNZ raises awareness of prostate cancer in New Zealand and provides vital support and resources to men with prostate cancer and their families.
Every year PCFNZ commits significant funds to New Zealand-based research on finding better diagnosis and treatment options for prostate cancer.
The Foundation is 100 per cent funded by donors and receives no direct government funding.
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