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Experts: Prostate cancer test erratic

ELDORET: If you are leaning towards 50, an African male and thinking of prostate screening, cancer experts at Moi Teaching and Referral Hospital say the available standard test is not very reliable.

Normally such a prospective patient will go through what is called Prostate Specific Antigen (PSA) test but now local cancer experts are saying this test is not appropriate for African men.

A team led by Dr Pius Musau have looked at screening results of 219 patients at the Urology Outpatient Clinic and Surgical Ward at the hospital and concluded that the test gives unacceptably high levels of misleading results.

The team found high levels of the protein in the blood of a significant number of patients even while they did not have cancer.

The team says the indigenous black African man has high levels of PSA even when he does not have prostate cancer. Consequently, subjecting him to this test, the team writes in the East African Medical Journal, may lead to over-diagnosis and possibly wrong management of their condition.

"We recommend that studies should be conducted to find a test appropriate for the African male which could replace the PSA altogether," they say.

The test measures the blood levels of PSA, a protein that is produced by the prostate gland. Usually the higher a man's PSA level, the more likely it is that he has prostate cancer.

The controversy about the suitability of this test in detecting prostate cancer, which only affects men, is not new.

Studies have shown that higher rates of PSA in black Americans than among whites but no studies have been carried out among indigenous African males.

"Depressingly, there is literary no data on the indigenous black African and how he fits in the mix. Our study makes an effort to utilise clinical and laboratory data to gain a glimpse into the magnitude of the challenge," they say.

According to the head of the Nairobi Cancer Registry Ann Korir, prostate is the highest cancer among men in the country.

"We only register a case of prostate cancer after it has been confirmed through biopsy because we know PSA is not a very reliable tool and gives a lot of false positive," says Korir.

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