The National Screening Committee has come under increased pressure in recent months to reconsider PSA testing policy, according to documents.
This is related to Sir Chris Hoy’s sad announcement that he had been diagnosed with terminal cancer, they said.
And, answering a question in parliament this week, health ministers said they were ‘carefully’ looking at the issue.
In minutes of a screening committee meeting held on 24 November, the NSC said they had ‘received increased calls to look at prostate cancer screening’ since Sir Chris’ diagnosis had been made public.
The six-times gold Olympic medal winner announced he was diagnosed with stage 4 prostate cancer in September 2023 after seeking help for pain in his shoulder.
Speaking publicly in October, the 48-year-old said the disease had spread to his bones and he had been given between two to four years to live.
It has renewed calls for a prostate cancer screening to be introduced. Under the currently policy PSA testing is not routinely offered on the NHS but men over the age of 50 years can request it from their GP.
In the minutes the screening committee said it ‘does not currently recommend screening for prostate cancer while the Prostate Cancer Risk Management Programme (PCRMP) provides guidance for GPs on how to counsel asymptomatic men on the potential benefits and harms of PSA testing, emphasising informed consent and choice for patients.’
It reiterated that the committee had commissioned a modelling study after submissions from the previous annual call to look at strategies to offer prostate cancer screening.
A range of options is under consideration, including a targeted service for men at higher risk due to factors such as ethnicity and family history.
The committee is also reviewing research suggesting MRI scans may be a way to more accurately detect prostate cancer.
Those at the meeting in November were told that preliminary data from the modelling study is being reviewed, ‘but complete findings will not be available until next year.’
The committee did note that a BBC Radio 4 ‘Inside Health’ programme featuring Sir Chris Hoy received positive feedback for its well informed and nuanced discussion on prostate cancer and screening.
‘Prostate cancer guidance and potential screening are high priorities but require robust evidence and careful consideration of assumptions. The UK NSC is actively engaging in discussions and reviewing emerging data,’ the committee said.
In response to a parliamentary question this week on when prostate cancer screening would be introduced, health minister Andrew Gwynne said they were ‘looking at the issue carefully’.
‘According to the current guidance, screening for prostate cancer is not recommended in the UK because of the inaccuracy of the current best test for prostate-specific antigen. Indeed, it could actually harm men, as some might be diagnosed with a cancer that would not have caused them problems during their lives,’ he said.
‘However, I am looking at this carefully, and I know that further information has gone to the National Institute for Health and Care Research so that it can, perhaps, reach a different conclusion.
‘Obviously, as technology and other mechanisms advance, this may well be an area where we can make inroads.’
Mr Gwynne also announced the Government was launching a call for evidence to inform a new National Cancer Plan to be published later this year.
Earlier this month, Prostate Cancer UK called for changes to the current policy so that GPs could discuss PSA testing with Black men from the age of 45 years.
The charity said data from the National Prostate Cancer Audit shows that Black men have higher rates of stage 3 and 4 prostate cancer diagnoses than any other ethnic group.
One Europe-wide study published last year found that marked differences in PSA testing and prostate cancer diagnosis between countries compared with much less variation in mortality was indicative of overdiagnosis related to ‘screening’.
Another analysis published in November by US researchers concluded that the adverse effects and complications after treatment for prostate cancer are ‘substantial’ and last for years.
“the Prostate Cancer Risk Management Programme (PCRMP) provides guidance for GPs on how to counsel asymptomatic men on the potential benefits and harms of PSA testing, emphasising informed consent and choice for patients.’”
THIS is the current problem.
The NOT ‘Programme’ that requires us to counsel any and all interested patients on screening vs not screening on an INDIVIDUAL patient basis for HALF the population for ONE THIRD of their lives is frankly a MASSIVE INSULT to GPs to pretend like this is a valuable use of our time to somehow explain ANNUALLY to someone that the test they want is not good enough to meet the standard of a screening test but that they can have it anyway if between themselves and their GP they can make more sense of the statistical value (or lack thereof) of having the test, where expert statisticians cannot!
It is also regressive and discriminatory as it is not a universally known invitational programme, but advantages the wealthy, literate, native English speaking patients who despite there not being a programme, know they can ask for it so long as a GP appointment is wasted on senseless counselling.
Either do an ACTUAL SCREENING PROGRAMME. Or Remove asymptomatic testing. This half in, half out situation is incredibly tedious and burdensome on the patients and clinicians (GPS exclusively) expected to deal with its idiocy,
FML
P.S
All the while we additionally have all manner of celebrities on the media channels consumed by baby boomers (print and TV) and the biggest household name (to baby boomers) politicians of all stripes*, popping up ad infinitum telling people explicitly or implicitly to ‘just get tested’ when there isn’t a statistically validated Programme according to those who apparently know better.
If we must have a “NOT A PROGRAMME PROGRAMME” just let them take a leaflet and book a blood test without wasting a GP appointment that could be used for actual assessment and treatment of illness (you know, like GMS). In my experience, as a full time male GP who must see atleast as many as any GP out there, they almost all go ahead after the highly variable and apparently useless counselling on the complexities of the apparently low value of screening- a waste of breath as well as appointment.
*Patrons of prostate cancer uk –
The Rt Hon Tony Blair
The Rt Hon Sir Nick Clegg
The Rt Hon Sir John Major KG CH
DRE remains the other rather large elephant in the room
Derogatory us of the term baby booker is unacceptable, even if the point behind it is valid.
That was of course “boomer”