The Editor, Sir:

Prostate cancer is not only the most common cancer affecting Jamaican men, but it is also the most common cause of male cancer-related deaths. In recognition of this, the Jamaica Urological Society (JUS) published local screening guidelines more than five years ago, recommending that all Jamaican men 40 years and older should have an annual digital rectal examination (DRE) and prostate specific antigen (PSA) blood test.

It further recommended that if either or both of these were abnormal it should be followed by an ultrasound-guided biopsy of the prostate gland to determine whether cancer is present.

These locally published guidelines were quite 'aggressive' given the fact that the issue of prostate cancer screening is controversial.

To date, screening for prostate cancer has not been shown to unequivocally decrease death from prostate cancer. As an indication of the controversial nature of this subject, of the 12 or so major North American medical associations, only three recommend prostate cancer screening, while the others are either ambivalent or outrightly oppose it.

Weekly screening clinics

Despite this, the Jamaica Cancer Society (JCS) provides weekly prostate cancer screening clinics at which the services of local urologists are offered without charge. These clinics have been in operation for more than 10 years and it is only in recent times that there has been increasing utilisation of them by the public.

A few years ago, for example, only 200 men availed themselves of this service in a one-year period compared to 8,000 women having had mammograms at the JCS during the same period. Underutilisation of prostate cancer screening services by men is not unique to Jamaica, but is characteristic of men everywhere.

Each year the JCS has an entire month dedicated to prostate cancer awareness as is also done for breast cancer. During this period there is a public forum on prostate cancer at which the members of the JUS address the audience on various aspects of diagnosing and treating prostate cancer.

Those forums held in Kingston at the Jamaica Conference Centre have been well attended by men (and women) from all strata of society and were an overwhelming success. Moreover, various members of the JUS address the public via the electronic and print media during this period and indeed throughout the year, on the issue of prostate cancer.

Taken seriously

The urological community in Jamaica takes prostate cancer very seriously and uses every opportunity to educate both members of the medical profession and the lay public about this disease. This is done both collectively as an organisation as well as individually.

Members of the JUS can attest to the numerous church groups, conventions, service clubs, corporate entities, sports clubs and health fairs that they have addressed over the years on the issue of prostate cancer. Moreover, the JUS at its yearly symposia always has prostate cancer on its agenda in keeping with its mandate to inform the medical profession on common urological disorders. It is on this background that I regard as unfortunate and unfair the claim that we have been 'cavalier' regarding our approach to prostate cancer in Jamaica, which was attributed to Alfred McPherson in the January 21 edition of the Outlook magazine. Mr. McPherson obviously has strong negative feelings about his urological care in Jamaica given his recent experience, but this does not excuse his comments which could have been avoided had he availed himself of the facts.

I am, etc.,

Dr. WILLIAM AIKEN, DM, FRCSEd

Lecturer in surgery (urology), UWI

Immediate past president,

Jamaica Urological Society