Health Secretary to Need Prostate Cancer Screening
So, the Secretary of State for Health , Matt Hancock , has discovered he has a genetic predisposition to develop Prostate Cancer (PCa).Without more clinical information, particularly Matt Hancock’s family history of PCa on the male side and breast cancer on the female side, it is difficult to comment on his individual case. However, we do know that about 10% of men presenting with PCa, particularly those presenting at a “younger” age in their 50s and 60s have a familial genetic predisposition to develop PCa. Such men need to know the risk and to be in a screening programme for PCa from their 40s. At present the only freely available NHS test to do this is the simple blood test Prostate Specific Antigen (PSA). Though it is not a perfect test, it is entirely adequate to screen such men and until a better test arrives, men at risk should have a PSA test every year or two from their 40s to age 70.
Unfortunately 90% of men who develop PCa in the UK have no known risk factors. In the UK PCa is diagnosed in 47,000 new cases and kills nearly 12,000 men every year – more now than breast cancer where the death rate is falling whilst for PCa it is rising! In all the countries using PSA routinely to screen for PCa the death rate has fallen by about a half but there has been no comparable fall in the UK where our cure rates for PCa lag well behind our European neighbours. Despite the availability of PSA and NHS Guidelines that clearly entitle men over 50 to have PSA tests, over a half of newly diagnosed cases in the UK have advanced, incurable PCa.
In the UK the previous disadvantages of PSA use ( so called “overdiagnosis and overtreatment” ) have been virtually eliminated by advances in specialist diagnosis and treatment of PCa over the last 5 years. GPs need to know this and also be aware that in Europe numerous clinical studies on PSA screening are showing that when used properly for appropriate and fully informed men, PSA screening can halve the death rate from this thoroughly unpleasant cancer now killing one UK man every 45 minutes! It is now up to UK men to be aware of the risk this commonest of all male cancers poses and GPs to use PSA proactively according to our existing NHS entitlement.”
Chris Booth, MBBS, FRCS, Clinical Director, CHAPS Men’s Health Charity.