The Decibel Rise in late-stage prostate cancer raises concerns over testing
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Dec 11, 2025 Kelly Grant, a health reporter for The Globe and Mail specializing in public health, delves into the alarming rise of late-stage prostate cancer diagnoses in Canada. She highlights the dramatic increase in Stage 4 cases among different age groups and discusses the controversial guidelines surrounding PSA screening. Grant explains the risks of the PSA test, the pros and cons of active surveillance, and the factors impacting who has access to testing. She also touches on the challenges faced by the Canadian Task Force on Preventive Healthcare in issuing new recommendations.
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Rise In Late-Stage Prostate Cancer
- Late-stage (stage 4) prostate cancer diagnoses rose notably in Canada between 2010 and 2021, especially among men 50–74 and 75+.
- The study found ~50% increase for ages 50–74 and ~65% increase for 75+ over that period.
Stage Dramatically Changes Prognosis
- Stage 1–3 prostate cancer is almost always curable, while stage 4 is considered incurable though treatments may extend life.
- Finding cancer earlier dramatically improves curative outcomes compared with metastatic disease.
PSA Use Sparked Overdiagnosis Concerns
- PSA testing began as a monitoring tool then expanded to screening in the late 1980s and 1990s, triggering large increases in diagnosed prostate cancer.
- That surge prompted concerns about overdiagnosis and overtreatment.