An outreach project to increase early detection of prostate cancer by targeting men less likely to have health checks and more likely to have a late diagnosis is to be rolled out across North and South-West London over the next year.
It follows a pilot of the ‘Man Van’, developed by the Royal Marsden NHS Foundation Trust, which visited areas with poor health outcomes and invited eligible men to come for a health check through a text from their GP.
Of more than 600 men who visited the van 14 were diagnosed with prostate cancer, mostly through high PSA levels identified through a blood test given in the van.
Nine of the cancers were classed as significant, which meant treatment was likely to be needed to prevent the disease from progressing, the Royal Marsden reported.
Black men were particularly targeted by the project, which was focusing on men over the age of 45, because they have double the risk of developing prostate cancer and an increased risk of death once diagnosed.
The pilot results showed Black men made up 29% of those seen and 71% of those diagnosed with prostate cancer.
The figures so far suggest the outreach approach targeting those particularly at risk may detect a higher proportion of cancers that need treatment than a general screening approach would which will be assessed further in the next phase of the project to provide 4,000 health checks over the next year.
Other health checks were done at the same time by the ‘Man Van’ team with, 18 (5% of those tested) men were diagnosed with diabetes, over a quarter (28%) with possible hypertension and 74% with an elevated body mass index.
Dr Mohan Sekeram, GP Principal at Wideway Medical Practice in Merton, said the project represented outreach at its best.
‘When the Man Van visited our neighbourhood last year, we worked with the service by inviting our eligible registered patients to book an appointment via text.
‘This priceless service supported our local primary care network and it was incredible to see how many men took up the offer for a health check.’
He added: ‘If rolled out more widely, I think the service could relieve pressure on GPs by offering tests typically carried out in a primary setting and, as a result, help speed up the diagnosis of prostate cancer and other conditions.’
Professor Nick James, professor of prostate and bladder cancer research at The Institute of Cancer Research, London, said: ‘The Man Van is an innovative community-centred initiative that offers health checks with a focus on prostate cancer to men known to be at high risk of late diagnosis close to home and in the workplace.
‘These pilot results, while based on small numbers, indicate the van could be an effective way of improving healthcare access for a range of issues faced by men as well as targeting those at highest risk of prostate cancer, potentially speeding up detection of the disease.’
So what did they do with the 35% that weren’t significant??
National screening committee advises against prostate screening due to lack of evidence that early detection improves outcomes.
Which makes this initiative rather puzzling.
Cancer research UK advised that asymptomatic PSA doesn’t meet any screening criteria and causes harm with no proven reduction in mortality rated
Dear All,
600 patients, 14 (2.3%) cancers found of which 9 (1.5%) were serious. And this in an area of deprivation. Not applicable everywhere I think.
And as usual do you need a doctor in a van to determine that a person is obese?
Regards
Paul C
“Priceless”
No it wasn’t.
The money came from somewhere. Nowadays that usually means funding PCN froth at the expense of core GMS.
This is a pilot project evaluating an outreach approach in areas with high rates of late diagnosis. We will assess both effectiveness and cost effectiveness. We are also checking BP and HbA1c. So far over 20% have had undiagnosed hypertension and around 5% diabetes. We have had GP input and buy in at every stage as evidenced by the enthusiastic quote. We will be analysing the results with NHSE. The present ad hoc GP based systems currently fail far too many men who present with advanced prostate cancer via A&E too late. Something none of these comments mention. GP services are hard pressed and novel ways of addressing unmet need I would have thought were welcome.
Incidentally the EU now recommend all member states set up PSA based screening programmes in conjunction with use of MRI assessment. This is based on the latest analyses of the European screening trials in particular. Details here https://ec.europa.eu/commission/presscorner/detail/en/qanda_22_5584
The UK currently has one of the worst cancer outcomes in Europe. The present system is failing our patients.