Prostate cancer screening urgently needed
Former chancellor Rishi Sunak has stepped up calls for a targeted screening program for prostate cancer.
In an interview with the BBC, he said he was convinced of the “urgency” of launching such a program which was affordable, feasible and would “save countless lives”.
His comments come as the UK’s National Screening Committee reconsiders its decision five years ago not to recommend routine screening.
According to media reports, it may continue its current stance.
Olympic cycling champion Sir Chris Hoy, who has advanced prostate cancer, wants young men to be checked.
He wants the age threshold for requesting a PSA (prostate specific antigen) blood test to be lowered.
It is not currently routinely offered to asymptomatic men under the age of 50.
PSA testing remains controversial, however. Levels can rise for reasons other than cancer, such as infections, which can lead to false positive results. Critics say this can lead to unnecessary treatment and side effects.
Sunak is Türkiye’s ambassador Prostate Cancer Researchwhich published a report on the costs and benefits of a targeted screening program.
It will focus on men ages 45 to 69 with a family history of prostate cancer and black men who face double the risk. This group includes approximately 1.3 million men in the UK.
The charity estimates the program will cost £25 million a year (about £18 per patient), similar to bowel and breast cancer screening. It is assumed that 20% of eligible men will be invited annually, for a participation rate of 72%. Diagnostic activities (scans and biopsies) should increase by 23%, but there should be only a small increase in the number of NHS staff, the report says.
According to the report’s authors, the benefits of targeted screening for people at highest risk outweigh the financial and logistical costs.
Speaking to the BBC, Sunak said: “I’ve had family and friends who were affected by it – thankfully they didn’t lose their lives – but it made me realize partly why it’s so important to catch it early – doctors are now very good at treating you if you catch it early.”
He said men, including himself, are often reluctant to come forward to discuss health problems: “So a proactive targeted screening program can make a difference in helping save lives.”
The screening programme, supported by the Prostate Cancer Research Charity, will include an MRI scan as well as a PSA test followed by a biopsy.
Asked whether he could have done more to advance the issue of prostate cancer screening while in Downing Street, Sunak said the tests had now become more reliable: “What has changed is the use of MRI scans, so we can now target the people who need our help most in a much more effective and safe way – it’s now available and affordable.”
But some medical experts are skeptical about the value of screening. They argue that there is still a risk that patients will receive cancer treatment when it is not absolutely necessary and then have to live with side effects such as urinary incontinence and erectile dysfunction.
Professor Hashim Ahmed, Head of Urology at Imperial College, says more research is needed to determine the potential value of screening.
“The problem is that we can often end up with diseases that don’t need to be treated and end up causing harm… and my concern right now is that the harm-benefit equation isn’t quite right.”
The National Screening Committee will have to weigh the evidence and allegations. The new report from Prostate Cancer Research said the implications for staffing and availability of a screening program would be manageable, while others argued it would eliminate screening capacity for patients being treated for other conditions.
Patient voices also shape the discussion. Sunak met David Bateman, 66, during a recent visit to the prostate cancer clinic at Guy’s Hospital in London. He was diagnosed with cancer at the age of 59 after requesting a PSA test and was told it had spread to his pelvis.
Since then, he has been receiving chemotherapy, radiotherapy and hormone therapy, but he remains incurable. David supports screening potentially vulnerable people.
“This is very important to me because my sons are 38 and 40 years old. I want them to be checked as soon as possible. If I had been scanned at 50, I am sure I would not be in the situation I am today,” he said.
