The charity Prostate Cancer Research has called for screening of men over the 45 who are born with a high risk of prostate cancer. The move follows a call from the Olympic cyclist Sir Chris Hoy for younger men and those with a family history of the disease to be tested as a matter of routine.
Sir Chris Hoy, 48, announced last month that his cancer is terminal, following a diagnosis of primary cancer in his prostate that has spread to his bones and other parts of his body. His cancer was only discovered after a routine scan of his shoulder revealed a tumour.
The case for a national screening programme
Men’s rights groups have been advocating for a national prostate cancer screening programme for several years, arguing that there is no equivalent to the national screening programmes for female cancers such as breast and cervical cancer. Men over the age of 50 are entitled to request a blood test, but not all men realise this or take up the opportunity.
BBC News reports that Oliver Kemp, head of the charity Prostate Cancer Research, said the current system is not working: “Not everyone is even aware that they have a prostate, never mind that they are at higher risk. Not as many people are turning up to their doctors as they should be.”
The case against a national screening programme
Some medical professionals argue that the reason there is no screening programme in place is not because of discrimination against men, but because the prostate-specific antigen (PSA) test is not a reliable enough indicator of disease. The test measures PSA levels in the blood.
However, PSA levels can be elevated for a number of reasons, and it is not always a sign of cancer. They can also remain normal even if prostate cancer is present. There are also concerns that more men would end up undergoing invasive cancer treatments with aggressive side effects for slow growing cancers that would not have caused any issues.
One of the long term side effects of some types of prostate cancer treatment such as surgery or radiotherapy is erectile dysfunction (ED). Men who are experiencing ED as a result of treatment are advised to consult their medical team. ED can be successfully treated in many cases with oral medication such as Cialis, more cheaply available as tadalafil.
Call for high-risk groups to be prioritised
Despite concerns that the test is imperfect, advocates for screening argue that more men are dying of prostate cancer, and lives could be saved with a more comprehensive screening programme for high-risk men.
Laura Kerby, Chief Executive of Prostate Cancer UK, said: “One in eight men will be affected by prostate cancer in their lifetime, but men like Sir Chris, who are 45 and over and with a family history of the disease, as well as Black men, are at significantly higher risk of prostate cancer at a younger age.”
“The PSA blood test is the first step to early diagnosis, yet GPs are prevented from offering this test and discussing prostate cancer risk with men like Sir Chris because of current NHS guidelines, which treat all men the same.”
“We believe no man should die of prostate cancer. That’s why we’re urging the government to refresh these outdated rules and begin saving thousands of lives today.”
Clive Efford, the MP for Eltham and Chiselhurst, who was himself diagnosed with prostate cancer in November 2023, said: “Despite knowing that my family history significantly increased my risk of prostate cancer, my doctors were incredibly dismissive when I asked for a PSA blood test.”
“I was lucky that my cancer was caught early and I’m now in remission, but sadly this is not the case for everyone.”
“The government must do all it can to make sure UK guidelines reflect the evidence, and until we have the evidence for a screening programme, we must allow GPs to speak to men at higher risk of prostate cancer about their option to have a PSA blood test.”
Prostate Cancer UK argues that current NHS guidelines on testing are outdated and are failing men. They are calling for fairer access to tests and MRI scans, and improved support for research programmes in the diagnosis and treatment of prostate cancer.
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