A study of more than 5,000 West Australian men, found that they are being diagnosed with prostate cancer too late, with many high-grade tumours and sometimes due to delayed referral for biopsies by their GPs.

The findings of the six-year study, will start a discussion about the value of the controversial PSA blood test, which has long divided doctors and cancer experts.

Almost 60 per cent of WA men, referred for prostate biopsies between 1998 and 2004 were found to have cancer, according to the research published by the Nature journal group.

The rate actually doubles that of men in the US, which has been exposed to more aggressive early screening at that time.

Of the 60 per cent diagnosed with prostate cancer, it was found that 69 per cent of tumours diagnosed on a first biopsy were found to be high-grade.

The overall rates of cancer and high-grade tumours were 60 per cent higher in WA patients compared with those in the US.

Prostate specific antigen or PSA test which had been recommended for men in their 50s according to the Urology Society of Australia and New Zealand last year, should now be offered to men in their 40s to assess their risks and whether they need closer monitoring.

Other medical groups questioned the advice, and warned against recommending routine testing at a particular age, and said men should be able to weigh up the benefits and risks.

David Malouf, society president, however said the latest study validated the need for early diagnosis and treatment.

This suggests we may be under-diagnosing prostate cancer in Australia, with GPs in some instances delaying the referral of patients with elevated PSAs for assessment, he said.

Tom Shannon, co-author of the study and urologist of Hollywood Specialist Centre said many men were being treated to late, and the rate of insignificant cancers was low.

The findings at odds with the common view that men were being over-treated for prostate cancer, acknowledged Dr Shannon.

He said doctors used several factors, including the PSA test in their decision whether the patient should undergo a biopsy, so few of those that were carried out were unnecessary.

Medicine Cancer