Teenagers and men in their 20s and 30s are having controversial prostate cancer tests in a de facto screening program that is worrying some Australian doctors.
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GPs and cancer specialists say prominent men's health campaigns such as Movember may be causing young men to have prostate specific antigen blood (PSA) tests despite an increasing number of expert groups recommending against their use.
A Prostate Cancer Foundation of Australia survey of 1243 men aged 18 to 50 this year found 8 per cent - or 67 of the 837 men aged under 40 - said they had been tested despite the disease being rare in their age group. Within this group, 6 per cent of 72 respondents aged 18-19 said they had had a test.
In 2009, only eight of the 19,000 Australian men diagnosed with prostate cancer were under 40.
Most said they had the test not because of experiencing symptoms but because they were concerned about the possibility of cancer.
A report on the survey concluded that ''despite public health and primary care advice to the contrary, Australia has an unorganised de facto screening program for prostate cancer being delivered in general practice''.
PSA tests are controversial in the medical profession as they are unreliable and there is conflicting evidence about the benefits and harms for healthy men with no symptoms of prostate cancer.
Research shows that while PSA tests may lead to earlier detection and prevent the spread of cancer in some men, there is inconsistent evidence they reduce death rates.
There also is rising evidence of harm. Studies suggest that for every 1000 men tested, 87 men who do not have prostate cancer will have a false positive PSA test that could lead to a harmful biopsy.
Some urologists say they are a useful screening tool for men in their 40s and that there is strong evidence they will reduce death rates for men in their 50s and 60s.
However, the Royal Australian College of General Practitioners disagrees and says the tests should not be discussed with men of all ages unless they ask for them.
Melbourne cancer specialist Ian Haines said given the statistics on harms, healthy men under 50 should not be having PSA tests.
The president of the Royal Australian College of GPs, Dr Liz Marles, said men's health campaigns may be driving younger men to request the tests from doctors who fear the consequences of saying no.
The chief executive of the Prostate Cancer Foundation of Australia, Dr Anthony Lowe, said his group was working with the Cancer Council of Australia to produce uniform guidelines across all medical practices. He hopes they will be released by December 2015.
