Public health messaging around prostate cancer places a misleading focus on urinary symptoms and may be hampering efforts of early detection, scientists have warned.
Cambridge University researchers said there was "no evidence of a causal link between prostate cancer and either prostate size or troublesome male urinary symptoms".
However, public health guidance regularly promotes this link, with an increased need to urinate high on the list of symptoms for prostate cancer given on the NHS website.
In a review published in the journal BMC Medicine, the researchers argue the "strong public perception" male urinary symptoms are a key indicator of prostate cancer "may be seriously hampering efforts to encourage early presentation".
"If rates of earlier diagnosis are to improve, we call for strong clear messaging that prostate cancer is a silent disease especially in the curable stages and men should come forward for testing regardless of whether or not they have symptoms," the paper says.
"This should be done in parallel with other ongoing efforts to raise awareness including targeting men at highest risk due to racial ancestry or family history."
Prostate cancer is the most common type of cancer in men. More than 52,000 men are diagnosed with it each year and there are more than 12,000 deaths, according to Cancer Research UK.
More than three-quarters (78%) of men diagnosed with the disease survive for more than 10 years, but that proportion has barely changed over the last decade in the UK - mostly because the disease is detected at a relatively late stage.
In England nearly half of all prostate cancers are picked up at stage three of four.
Vincent Gnanapragasam, professor of Urology at Cambridge University, said: "When most people think of the symptoms of prostate cancer, they think of problems with peeing or needing to pee more frequently, particularly during the night.
"This misperception has lasted for decades, despite very little evidence, and it's potentially preventing us picking up cases at an early stage."
While prostate enlargement can cause the urinary problems often included in public health messaging, evidence suggests it is relatively rare due to malignant prostate tumours, the researchers said.
Instead, research suggests the prostate is smaller in cases of prostate cancer.