According to our research on this issue, it appears the survival rates for prostate cancer in men are actually very good once treated, but of course in order for this to be so, the cancer has to be detected, and early enough in the first place.
In 2015 it was reported that for the first time deaths from prostate cancer overtook that of breast cancer. The reason for this is considered to be routine mammograms for women helping with detection. We believe that a national screening programme whereby men over the age of 50 are invited to have a PSA blood test would certainly improve detection and therefore survival rates on this type of cancer.
The PSA (Prostate Specific Antigen) blood test indicates the risk of developing prostate cancer, and a reading of over 10 can indicate the risk could be as high as 65%. A reading such as this could then result in a biopsy and potential earlier diagnosis and treatment if necessary. We do understand from our research that the readings from this blood test would increase with age and there may be other factors that could affect it, but surely it is the best starting point to try and detect any cancer sooner rather than later. The cost of implementing such a screening programme is surely balanced out by the fact that later diagnosis would cost the NHS more in the long run. Women have breast and cervical screening in place, surely this screening programme for men should be given equal consideration, and importance, to help save lives in the long run.
Reply from: Rory Howard – Ministerial Correspondence and Public Enquiries, Department of Health and Social Care
With regard to PSA screening, if a person wishes to access a PSA test, they should speak to their GP. It is for the GP to decide if a test is clinically appropriate in individual cases, as there are issues with the accuracy and potential consequences of the PSA test.
There are no plans to make changes to the general availability of the test.
The UK National Screening Committee (UK NSC) advises ministers and the NHS about all aspects of screening policy, and reviewed the evidence for screening men for prostate cancer in 2015. Whilst it found that the evidence suggests that prostate screening does reduce prostate cancer deaths, the Committee’s overall recommendation was that a national screening programme for prostate cancer should not be offered because:
- the PSA test is neither very specific nor very sensitive, and is unable to distinguish between slow-growing and fast-growing cancers;
- there is a risk that a national screening campaign would lead to a high number of false positives;
- treating men who have false positive tests can result in impotence, incontinence and rectal problems;
- there is currently no viable alternative to the PSA test, but evaluation is currently taking place that could have the potential to improve the accuracy of PSA testing to identify men at greater risk for fast-growing prostate cancers; and
- the Committee felt that the risk of administering unnecessary and harmful treatments in the case of false positives outweighed the potential reduction in prostate cancer deaths.
The UK NSC will be reviewing evidence for prostate cancer screening in 2019/20.
There have been efforts in recent years to develop risk prediction tools that use different blood tests and various characteristics, such as size of prostate and age, in addition to PSA to more accurately assess whether someone has clinically significant prostate cancer. The UK NSC, the National Institute for Health and Care Excellence and the NHS are keeping a close eye on the evidence as it develops.
I hope this reply is helpful.