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Overdiagnosis of Prostate Cancer May Explain Wide Variations in Incidence Across Europe, Study Finds

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Prostate Cancer

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.

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“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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Study Finds Men Far More Likely Than Women to ‘Hit the Wall’ in Marathons

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Men are significantly more likely than women to experience the dreaded marathon phenomenon known as “hitting the wall,” according to a large international study that analysed the performances of more than 870,000 runners over a 26-year period.

The research, published in the journal Scientific Reports, examined the results of 873,334 finishers in the Berlin Marathon between 1999 and 2025. Researchers found that although men generally complete marathons faster than women, they are much more likely to suffer a dramatic slowdown during the later stages of the race because of less consistent pacing.

According to the study, men are almost twice as likely overall to experience a sudden decline in speed during a marathon. In some performance categories, they were found to be up to six times more likely than women to “hit the wall,” a term commonly used to describe severe physical exhaustion caused by depleted energy stores.

Researchers said the findings point to differences in race strategy rather than physical ability alone. Men were more likely to begin races at an aggressive pace, increasing the risk of fatigue before reaching the finish line.

The study concluded that “men, regardless of performance level, are more prone to aggressive pacing and catastrophic deceleration.” The authors suggested that greater willingness to take risks and higher levels of confidence may encourage many male runners to start faster than they can realistically sustain over the full 42.195-kilometre distance.

Women, on the other hand, displayed more controlled pacing throughout the race. Researchers found they were better at regulating their effort from start to finish, reducing the likelihood of a significant loss of speed during the closing kilometres.

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The report described women as showing “superior self-pacing abilities and greater resistance to decision-making fatigue,” characteristics that can be particularly valuable during endurance events.

Maintaining a steady pace is widely regarded as one of the most important factors in marathon performance. Running too quickly during the opening stages can rapidly consume the body’s glycogen reserves, leaving athletes without enough energy to sustain their speed in the final part of the race.

The researchers noted that pacing is “the most critical tactical determinant of performance” in marathon running, making strategic decision-making just as important as physical fitness.

The findings could influence how coaches and runners prepare for long-distance races. Rather than focusing solely on speed, the study suggests that adopting a realistic race plan and maintaining a consistent pace throughout the event may improve overall performance and reduce the chances of a late-race collapse.

With marathon participation continuing to grow worldwide, the researchers believe a better understanding of pacing strategies could help runners of all abilities achieve stronger and more consistent results.

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Study Links Higher Coffee Consumption to Lower Risk of Liver Disease

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Regular coffee consumption may help reduce the risk of serious liver diseases, including cirrhosis, liver cancer and liver-related deaths, according to a new study published in the journal Clinical Gastroenterology and Hepatology.

The research found that people who consumed higher amounts of coffee, including decaffeinated varieties, were less likely to develop chronic liver conditions than those who drank little or no coffee. The findings add to growing evidence that coffee may play a role in supporting long-term liver health, although researchers stressed that the results do not prove a direct cause-and-effect relationship.

The study examined data from more than 350,000 participants enrolled in the UK Biobank, one of the world’s largest long-term health research projects. None of the participants had cirrhosis or liver cancer at the beginning of the study. Researchers monitored their health over a period of 13 years to assess how coffee consumption affected liver-related outcomes.

According to the findings, participants who drank five or more cups of coffee each day had a 32 percent lower risk of developing cirrhosis than those who consumed little or no coffee. They also recorded a 47 percent lower risk of liver cancer and a 42 percent reduction in deaths linked to liver disease.

Researchers found additional indicators of improved liver health among regular coffee drinkers. Participants with higher coffee intake showed lower levels of liver fat, liver iron, fibrosis and inflammation. Blood tests also revealed increased levels of proteins associated with healthy liver function, while markers linked to liver scarring and inflammation were generally lower.

The findings come as liver disease continues to pose a major global health challenge. A separate study published in 2023 estimated that liver disease causes around two million deaths each year, accounting for about four percent of all deaths worldwide. Men account for nearly two-thirds of those fatalities.

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Despite the encouraging results, the researchers urged caution in interpreting the findings. Senior study author Ju Dong Yang said moderate coffee consumption appears to be beneficial for people who already enjoy drinking coffee and tolerate it well.

“Our findings support moderate coffee consumption for people who already enjoy and tolerate it well,” Yang said.

He added that the study does not provide sufficient evidence to recommend that people who do not currently drink coffee should begin doing so solely to reduce their risk of liver disease.

Health experts continue to advise that maintaining a healthy weight, limiting alcohol consumption, eating a balanced diet and managing conditions such as obesity and diabetes remain the most effective ways to reduce the risk of chronic liver disease. Researchers said additional studies are needed to better understand which compounds in coffee may contribute to its potential protective effects.

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Lancet Review Finds mRNA Vaccines Safe and Highly Effective, Calls for Wider Global Access

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A comprehensive review of data covering billions of administered doses of mRNA vaccines has concluded that the technology remains both safe and highly effective in preventing infectious diseases, with researchers urging governments and health organisations to focus on expanding global access.

The review, published in The Lancet, examined evidence gathered since mRNA vaccines were first deployed on a large scale during the COVID-19 pandemic. Researchers found that the vaccines continue to provide strong protection against severe illness while serious side effects remain uncommon.

Unlike conventional vaccines, mRNA vaccines work by delivering genetic instructions that enable the body’s cells to produce a harmless viral protein. This process trains the immune system to recognise and respond to future infections without altering a person’s DNA.

According to the review, mRNA vaccines were 87% effective in preventing confirmed SARS-CoV-2 infections within 14 to 42 days after vaccination. The vaccines also demonstrated 93% effectiveness in preventing hospital admissions and 94% effectiveness in preventing deaths related to COVID-19 during the same period.

Researchers noted that immunity declines over time, but booster doses restore a significant portion of the lost protection.

The review also assessed vaccine safety across billions of administered doses. It found that serious adverse events, including myocarditis, pericarditis and anaphylaxis, occurred very rarely. Most reported reactions, such as pain at the injection site, fatigue and fever, were mild to moderate and typically resolved within a few days.

“Across billions of administered doses, serious adverse events have been rare, well characterised, and consistently outweighed by the substantial protection conferred against severe disease, hospitalisation, and death,” the researchers wrote.

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The review concluded that the vaccines have proven effective across a broad range of populations, including children, older adults, pregnant women and people with weakened immune systems.

Researchers also highlighted the growing potential of mRNA technology beyond infectious diseases. They said ongoing research could lead to personalised cancer vaccines designed to match an individual patient’s tumour characteristics, opening new possibilities for targeted treatment.

Co-author Manish Sadarangani of the University of British Columbia and BC Children’s Hospital Research Institute said mRNA vaccines have already changed how the world responds to emerging infectious diseases and could continue to play an important role in preventive medicine and cancer care.

The review also noted that improvements in vaccine storage, including higher-temperature storage methods and freeze-drying technologies, could simplify transportation, reduce waste and improve access in remote regions.

Despite these advances, the researchers stressed that manufacturing capacity and equitable distribution remain major challenges. They called for greater investment in local production, technology transfer and stronger regulatory systems, particularly in low- and middle-income countries.

Co-author Robin Shattock of Imperial College London said expanding manufacturing networks and strengthening regional production capabilities would shorten supply chains, lower costs and help ensure countries have faster access to vaccines during future global health emergencies.

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