Urologist Calls for Community-Based Prostate Cancer Screening

Consultant Urologist at the University Hospital of the West Indies, Professor William Aiken, is calling for prostate cancer screening to be taken directly to men in the communities and settings where they live and work as efforts continue to reduce deaths from the disease.

In an interview with JIS News, Professor Aiken, who is also Head of the Department of Surgery at the University of the West Indies, insisted that greater emphasis must be placed on reaching men who are not currently accessing screening, rather than relying solely on them to seek out testing.

“The problem is that the message is not getting out to the average man on the street,” he said. Professor Aiken noted that many of the men who currently present for screening are already well informed and proactive about their health. He is, therefore, advocating for greater outreach to men in their communities and workplaces, where they can be reached more directly with information and screening services.

The former President of the Caribbean Urological Association said early detection is critical because prostate cancer is generally silent in its early stages.

“Early prostate cancer does not cause any symptoms. Therefore, men need to screen to detect it early,” he said. He noted that the high mortality associated with prostate cancer in Jamaica can be reduced through early detection and treatment.

“No man needs to die from prostate cancer,” Professor Aiken said, arguing that the high mortality rate in Jamaica is “totally and completely unnecessary” and can be avoided if more men undertake screening.

Professor Aiken informed that in Jamaica, screening is recommended from age 40, and identified African ancestry, family history and increasing age as the three established risk factors.

He also pointed to dietary factors, including diets high in processed and red meats, animal fats and dairy products, as additional risks. Professor Aiken further cautioned men against relying solely on the prostate-specific antigen (PSA) blood test.

“If you do only the PSA, men will risk having undiscovered prostate cancer,” he warned. He explained that some cancers may not be detected through PSA testing alone and highlighted the importance of the digital rectal examination (DRE) as part of screening.

Professor Aiken cited the recent testimony of a prostate cancer survivor whose PSA was normal but had cancer which was detected through a DRE.

Therefore, men who choose to do only the PSA test risk having cancer go undetected he said.

Professor Aiken also highlighted the important role of women in encouraging men to undergo screening.

“Women play a critical role, because in many cases, it’s the women who bring the men or insist that the men go and get tested,” he said.

He suggested that engaging women could be an effective strategy for reaching more men with information about prostate cancer screening.

Professor Aiken further warned that Jamaica’s ageing population, combined with changing dietary habits and increased consumption of fast food and animal fats, could contribute to a growing prostate cancer burden.

He said the country already faces a significant challenge from prostate cancer and stressed that improving access to screening and reaching more men with the message are critical to reducing mortality.