Thousands of men risk being condemned to an avoidable death as government advisors reject calls for a major prostate cancer screening programme

Thousands of men are at risk of dying an avoidable death after government advisers today rejected calls for a major prostate cancer screening programme.

Health secretary James Murray will meet the chairman of the UK’s National Screening Committee on Monday before deciding whether to follow the advice or override it.

Charities, patients and MPs say Mr Murray, who only took up his post this month, must ‘show leadership’ and use his powers to challenge the bombshell guidance.

Prostate cancer is the most common cancer in the UK, with 63,000 cases and 12,000 deaths each year; However, unlike breast, bowel and lung cancer, there is currently no national screening program.

The Daily Mail is among those campaigning for an end to needless prostate cancer deaths and a national prostate cancer screening programme, initially targeting high-risk men such as those who are black, those with a family history of the disease or certain genetic mutations.

The UKNSC published draft guidance in November saying screening should only be offered to around 20,000 men aged 45 to 61 who have BRCA1 or BRCA2 gene mutations that increase the risk of aggressive disease.

This meant that black men, who are twice as likely to get and die from prostate cancer, and those with a family history of the disease would be excluded.

The panel now says fewer men should have routine checks than initially recommended, following public consultation and consideration of new evidence.

In its latest advice published today, the UKNSC says that only men aged 45 to 61 with certain BRCA2 variants with a family history of breast, ovarian, pancreatic or prostate cancer should take part in the programme.

This means as few as 3,000 men will be invited for screening, which will involve a blood test every two years to check for a potential prostate cancer marker known as PSA.

The committee said expanding screening to a broader group could lead to overdiagnosis and overtreatment, putting some men at risk of impotence and urinary incontinence when their tumors are unlikely to cause problems throughout their lives.

Rather than waiting three years to reevaluate his decision, as is usually the case, he promised to continue updating his model as new evidence becomes available.

But Chiara De Biase, director of fundraising and health strategy at Prostate Cancer UK, said: ‘We are deeply disappointed with this latest advice from the UKNSC.

‘Without a screening program for the most common cancer in the UK, we lose more than 12,000 fathers, brothers and partners every year.

‘We know that a mass screening program could save the lives of thousands of men, and while we recognize that the available evidence does not yet suggest that screening all men at risk would do more good than harm, today’s decision is a step backwards and narrows the recommendation to a smaller pool of eligible men.

‘We will carefully examine the evidence behind this decision and appeal where we disagree.

Former chancellor Rishi Sunak has backed calls for a national prostate cancer screening program targeting high-risk men.

‘We cannot accept the current situation. More must be done to save men’s lives, starting with those most at risk, including men with family history and black men.’

Prostate Cancer Research, meanwhile, expressed its “deep disappointment” at the committee’s recommendation and warned it would “doom thousands of people to preventable deaths while reinforcing health inequalities for another generation.”

David James, the charity’s director of patient projects and impact, added: ‘For men most at risk of prostate cancer, this decision will feel like they’ve been left behind.

‘The number of men affected by this recommendation is likely to be fewer than the Committee has previously stated.

‘We had hoped that the committee would recognize the very compelling case for screening those at highest risk, but today it is clear that these men are disappointed.

‘We know who is most at risk for this disease, but these men are still not offered screening services.

‘These men are often told to wait until it’s too late. It becomes impossible to defend this.

‘He said the committee model will be kept ‘alive’, which is important.

The Daily Mail is among those campaigning for an end to needless prostate cancer deaths and a national prostate cancer screening programme, initially targeting high-risk men such as those who are black, those with a family history of the disease or certain genetic mutations.

‘But it must now act quickly to update this model and reconsider this decision before more men are diagnosed too late.’

The decision to exclude almost the entire male population follows a large study last year that showed prostate screening reduced the risk of dying from the disease by 13 percent; For every 456 men controlled, one death was prevented; This figure is comparable to existing breast and bowel cancer screening programmes.

Between 21 and 35 in 100 men with the BRCA2 variant will develop prostate cancer before age 80.

UKNSC chairman Professor Sir Mike Richards told a briefing: ‘We are certainly aware of the strong support for prostate cancer screening in large numbers of people, but we are also aware of the real harm that the disease can cause, experienced by patients and indeed their families.

‘We know that screening can reduce deaths from prostate cancer to a small degree and does not improve overall survival.’

He said many men would ‘live full lives’ without the disease causing harm and that screening ‘can only help if it can distinguish harmful disease from harmless disease.’

“Once prostate cancer is found, we still cannot reliably tell which cancers need treatment and which do not,” Professor Richards said.

‘There is a spectrum here and current treatments for prostate cancer can cause long-term damage.’

UKNSC chief executive Professor Sir Mike Richards said many men would ‘live their lives to the fullest’ before prostate cancer caused harm.

Professor Richards also said levels of overdiagnosis in prostate cancer remained high “despite advances” such as MRI scans before biopsy following a positive PSA test.

The decision does not prevent men from proactively requesting a PSA test after discussing the risks and benefits with their GP.

The UKNSC said it had removed BRCA1 from the final guidance because of new data that emerged after publishing its draft.

Anneke Lucassen, professor of genomic medicine at the University of Oxford’s Nuffield Department of Medicine and director of the Center for Personalized Medicine, told the briefing that previous studies had ‘failed to clearly separate’ the risks posed by both BRCA1 and BRCA2 variants.

He said two recently published large studies suggest that when it comes to prostate cancer, the risk is mainly due to BRCA2, not BRCA1, and that the risk is ‘significantly lower’ in people with BRCA1.

Former prime ministers Rishi Sunak and David Cameron, who has described his battle with prostate cancer, have backed calls for a national prostate cancer screening program targeting high-risk men.

Wes Streeting, the health secretary when the committee published its draft guidance, promised to consider the results ‘carefully’ and consider the arguments to ‘get us on the right path forward’.

Prostate Cancer Research ambassador Mr Sunak said: ‘This decision will be deeply disappointing to the thousands of brave men who have campaigned for a targeted screening program to prevent more families losing a father, son or brother prematurely.

‘With just 0.01 per cent of the NHS Budget we could have a targeted screening program that could save lives.

‘Our problem is that prostate cancer is often caught too late, with devastating consequences for men and their families.

‘Today screening is more effective than ever, but the model that guided the Committee’s decision does not reflect these developments.

‘Updating this is essential if we are serious about early detection and preventing preventable deaths.

‘We must use this opportunity to save lives, reduce inequalities and bring prostate cancer screening into line with how the disease is diagnosed and treated today.’

Cancer Research UK’s chief policy officer, Dr. Ian Walker said: ‘Prostate cancer remains the second biggest cancer killer among men, so it is critical that we find more ways to save lives from this disease.

‘Today’s announcement, following an independent expert review, that the current evidence does not support a wider prostate cancer screening program will be disappointing to many, but the PSA test currently used to detect prostate cancer is not effective enough to support wider screening, as has been shown in multiple large-scale trials.

‘Screening decisions should be guided by available evidence; Programs should only be introduced when the benefits are shown to outweigh the harms, including unnecessary and invasive overtreatment.’

A Department of Health and Social Care spokesman said: ‘The Secretary of State will fully and carefully consider the advice of the independent UK National Screening Committee and will update on the government’s response shortly.’