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‘It basically says every man destined to die of prostate cancer, which is about four per cent, we should just let that happen’

Representatives of neither the American nor Canadian task forces were available to comment Thursday. The Canadian report cites evidence that PSA tests save the lives of at most one additional man per 1,000 screened. “Unfortunately, the PSA test is simply not an effective screening tool,” Edmonton’s Dr. Neil Bell of the task force said when its report was released.

The Toronto study, just published in the Journal of Urology, tracked 3,200 patients who underwent biopsies at one of the UHN hospitals from October 2008 until June 2013.

After the American report was released in May 2012, the average number of biopsies overall fell to 35 a month from 58 before the report. The average number of low-risk cancers detected dropped to 5.5 a month from 8.5.

And the number of diagnosed intermediate to high-grade prostate cancers — the most worrisome sort — shrunk to just 10 a month from 17.5 on average before, the researchers reported.

Both male family physicians and their male patients likely embraced the anti-PSA recommendations with some “relief,” given the hard-wired aversion of many men to medical intervention of any kind, speculated Dr. Fleshner.

Dr. Larry Goldenberg, a urology professor at the University of British Columbia, said he has not yet seen a similar decline in referrals or biopsies in Vancouver, but is concerned by Toronto’s trend toward fewer serious cancers being diagnosed.

“It means we are going to take a step back in time where we saw a lot more patients with metastatic cancer,” he said.