In their last review in 2015/16, the NSC did not recommend screening for the following reasons:
Evidence suggests prostate specific antigen (PSA) testing could reduce prostate-cancer related mortality by 21%. Despite this, the major harms of treating men who incorrectly test positive still outweigh the benefits.
The PSA test is a poor test for prostate cancer and a more specific and sensitive test is needed. The PSA test is unable to distinguish between slow-growing and fast-growing cancers.
Current evidence does not support a population screening programme using any other test.
valuation is currently taking place which could have the potential to improve the accuracy of PSA testing to identify men at greater risk of fast-growing prostate cancers.
The NSC is due to review prostate cancer screening again this year. As part of our campaign for earlier diagnosis, Tackle has long supported national screening for prostate cancer, particularly for men at higher risk and the evidence supports its introduction. So, we wanted to make our views known to the NSC..
We are extremely grateful to Chris Booth, a member of our Clinical Advisory Board, who has put together the submission on our behalf, the conclusion of which is:
The UK’s current annual death rate of 12,000 men – that’s one death every 45 minutes – is unacceptable and the argument that the harms of screening outweigh the benefits is no longer valid.
Despite awareness campaigns raising the profile of prostate cancer, the low rate of PSA testing in the UK has resulted in little opportunity to use the tools we already have for early detection, discrimination between aggressive and non-aggressive cancer and the cheaper option of early, curative treatment compared with late, expensive, palliation of advanced prostate cancer. Adoption now of proven, best practice use of PSA on a national scale could halve the UK death rate. However, Primary Care does not have the capability to manage such a programme.
In the light of this evidence, the status quo discriminates against men, is financially unsound and medically unsustainable. We therefore recommend a fundamental change in the utilisation and delivery of PSA screening commencing with men at high risk as the first steps in establishing an adequate, national approach to reducing the UK’s unacceptable death rate from this most pernicious cancer.
Read our submission in full here. We will keep you posted on developments.