Routine testing for COVID-19 for prostate cancer patients?

An article published in Communications Biology has suggested that all prostate cancer patients should be routinely tested fro risk of infection with COVID-19. This appears to be a questionable piece of advice for the average prostate cancer patient.

The full text of the article by Chakravarty et al. is available on line, and a related commentary (that may be an easier read for non-scientists) can be found on the Medscape web site.

One of the problems with the recommendation is that the data on which it is based come from a single institution in New York City at the time of the first “wave” of infection. The fact that an unusually densely packed population was exposed to COVID-19 early in the pandemic (between March 1 and April 17, 2020) has all sorts of ramifications which may not necessarily be applicable to all “average” prostate cancer patients.

At this point in time, it is worth noting the following:

  • These data are generally considered to be “preliminary”.
  • This recommendation is not currently supported by any major organization such as the American Urology Association or the American Society for Clinical Oncology or others.
  • An independent reviewer does not concur with this recommendation (see the Medscape commentary).
  • The authors themselves write that:

The true susceptibility of prostate cancer patients to COVID-19 remains unclear at this point, despite early evidence of overlapping biology and common comorbidities.

On the other hand, there is evidence that:

  • Men are at higher risk of COVID-19 infection and mortality than women.
  • Comorbidities among COVID-19-positive patients has been found to be higher in males than females.

Prostate Cancer International believes that there are certainly men who should receive routine testing for COVID-19 infection (if they are able to do this) because they are at high potential risk should they become infected and so early treatment of COVID-19 would be wise if it is necessary. On the other hand, we are also distinctly dubious about the need for routine testing among all prostate cancer patients.

Patients who have concerns about their risk for COVID-19 infection — particularly if they are undergoing treatment for high-risk, progressive, and advanced forms of prostate cancer — would be wise to consult their urologist or medical oncologist.

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