Health
Overdiagnosis of Prostate Cancer May Explain Wide Variations in Incidence Across Europe, Study Finds
A new study published in the British Medical Journal has revealed that overdiagnosis of prostate cancer in Europe could be contributing to significant differences in cancer incidence rates across countries. While incidence rates varied up to 20-fold between nations, mortality rates only fluctuated by about five times, highlighting a potential disparity in how the disease is being diagnosed and treated.
Overdiagnosis occurs when a tumour is detected that would not have caused symptoms or death during an individual’s lifetime, leading to unnecessary treatments that may negatively impact a patient’s quality of life. The study suggests that widespread use of PSA (prostate-specific antigen) testing, particularly through opportunistic screening, may be driving overdiagnosis.
“The results of this study are compatible with large overdiagnosis of prostate cancer occurring as a consequence of opportunistic screening with PSA testing,” said Dr. Salvatore Vaccarella, the study’s lead author and a scientist at the International Agency for Research on Cancer (IARC).
Prostate cancer is a significant health issue in Europe, representing nearly a quarter of new cancer cases among men in 2020, with over 70,000 deaths attributed to the disease that year. The risk of overdiagnosis and subsequent overtreatment is higher for prostate cancer than for other cancers, such as breast, cervical, or colorectal, the study noted.
Most European countries, except Lithuania, which has implemented a wide screening programme since 2006, rely on individual-based decisions for PSA testing rather than population-wide screening. However, the study warned that PSA testing as part of routine healthcare or opportunistic screening is not optimal for reducing population-level impacts.
A 2009 study found that 23% to 42% of men diagnosed through PSA testing would have lived without ever knowing they had prostate cancer, further raising concerns about the screening method. The researchers emphasized that any future implementation of prostate cancer screening must be carefully designed to reduce the harms of overdiagnosis.
“The results of this new study emphasize the importance of carefully designing prostate cancer screening to minimize overdiagnosis, with proper quality assurance and monitoring,” Vaccarella added.
The findings were based on an analysis of data collected from 1980 to 2017 from men aged 35 to 84 across 26 European countries. However, the researchers cautioned that the observational nature of the study means no direct conclusions about cause and effect can be drawn.
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Second Round of Polio Vaccination Begins in Gaza Amid Conflict
A second round of polio vaccinations commenced in Gaza on Monday, aiming to inoculate over half a million children as part of emergency efforts to control an outbreak first detected in July. The highly contagious virus was found in sewage samples and led to the paralysis of a 10-month-old child, marking the first polio case in the region in 25 years.
The initial phase of the vaccination campaign occurred in early September, with approximately 95% of eligible children receiving the first dose of the oral polio vaccine. The current round will provide the crucial second dose, necessary to halt the transmission of the virus. According to the World Health Organization (WHO), at least two doses are required to stop the spread, and a minimum of 90% vaccination coverage is essential to protect the population.
In addition to the polio vaccine, children between the ages of two and nine will receive Vitamin A to enhance overall immunity, the WHO reported.
Dr. Hamid Jafari, Director of Polio Eradication for WHO’s Eastern Mediterranean region, explained that polio outbreak responses typically involve multiple rounds of immunization to interrupt transmission at the community level. The Global Polio Eradication Initiative (GPEI) helps determine the number and scope of campaigns needed based on risk assessments, with this particular campaign targeting children under 10 in Gaza.
Vaccination Amid War and Shortages
The ongoing vaccination effort takes place under the shadow of the Israel-Hamas war, which erupted on October 7, 2023, when Hamas launched an attack in southern Israel. Israel’s subsequent military response, including airstrikes and a ground operation, has led to widespread devastation in Gaza, with more than 42,000 Palestinians killed, according to the territory’s health ministry.
The war has severely strained Gaza’s healthcare system, which WHO described as “virtually depleted.” The first round of vaccinations faced major logistical hurdles due to damaged infrastructure, a lack of supplies, and significant population displacement.
Despite these challenges, the first phase was considered a success, with mobile teams, outreach posts, and health facilities ensuring broad coverage. For the second round, similar strategies are being employed, with additional efforts to raise public awareness, including radio broadcasts and digital messaging.
In recent months, 1.6 million doses of the polio vaccine have been delivered to Gaza, along with essential equipment like refrigerators, freezers, and vaccine carriers.
Catherine Russell, Executive Director of UNICEF, emphasized the importance of “humanitarian pauses” in the conflict to ensure the vaccination campaign can continue without interruption, stressing that “without them, it is impossible to vaccinate the children.”
Global Polio Eradication Efforts
Polio is primarily transmitted through contact with the feces of an infected individual, often through contaminated water or food. While many people experience mild or no symptoms, the virus can cause paralysis and, in severe cases, death.
The ongoing global fight against polio has successfully reduced cases of wild poliovirus to just two countries, Afghanistan and Pakistan. However, outbreaks of vaccine-derived strains still occur in areas with low immunization rates. These strains, linked to the live virus in the oral vaccine, can be controlled with two to three rounds of immunization.
The novel version of the oral polio vaccine used in Gaza includes improvements designed to reduce the likelihood of the virus mutating and causing disease in under-vaccinated communities. Dr. Jafari stressed the importance of continued global cooperation, noting that “until we stop transmission of all polioviruses, children everywhere remain at risk.”
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