An NHS England medical director is one of a number of GPs who have raised concerns about communication from the Department of Health and Social Care encouraging men over 50 to check their risk of prostate cancer.
Last week, the Department of Health and Social Care tweeted: ‘One in eight men will get prostate cancer. Men at higher risk are: aged over 50; those with a family history of the disease; black men over 45. If that’s you, speak to your GP. Check your risk in 30 seconds: https://prostatecanceruk.org/risk-checker‘
But GPs have interpreted this as encouraging unofficial screening for prostate cancer, putting pressure on GPs services.
There is currently no screening programme for prostate cancer in England, with the National Screening Committee (NSC) concluding that PSA screening was not accurate enough to detect prostate cancer that needs treatment, and could lead to unnecessary and often unpleasant tests and treatment.
It is understood that the NSC is exploring a number of proposals around prostate cancer screening, including the possibility of targeting to certain groups.
A Pulse investigation in May found that an increasing number of charities and private companies are offering screening outside the approved NHS programmes, with one of the most prominent current example being prostate cancer screening with PSA testing.
Professor Alf Collins, NHS England’s clinical director for personalised care, said: ‘Is this right, DHSC? General practice on its knees yet you suggest all men over 50 might want to contact their GP regarding their prostate cancer risk.’
Professor Azeem Majeed, head of the Department of Primary Care & Public Health at Imperial College London, told Pulse: ‘DHSC staff will know that decisions about screening are based on guidance from the National Screening Committee, which currently does not recommend screening for prostate cancer.
‘I tried the calculator that was linked to the tweet and I did not find it useful (I was marked as “high risk” because of my age).
‘My advice to DHSC is to confine their health advice to guidance that has been approved by organisations such as NICE and the National Screening Committee.’
Dr Dave Triska told Pulse that the tweet was ‘absolutely encouraging an unofficial screening program’.
He said: ‘If the DHSC truly believe this is in the best interests of men’s health this should be funded and resourced, both in primary care and for the subsequent unnecessary investigations and treatment that will occur in secondary care.’
Dr Ed Turnham, a GP partner and chief clinical information officer at Norfolk & Waveney ICS, said: ‘There is no policy to screen for prostate cancer in England. If there were, I’m sure it wouldn’t be to tell 10% of the population to see their GP. If they all did so it would use up two weeks’ worth of all GP appointments.’
The DHSC told Pulse that the NSC is considering ‘a variety of proposals’ related to screening for prostate cancer and will explore these further and consider ‘how best to take them forward’.
The DHSC also said that the Prostate Cancer Risk Management Programme (PCRMP) provides asymptomatic men aged 50 and over and healthcare professionals with information about the potential benefits and potential harms of PSA testing for prostate cancer.
Pulse understands the committee is also awaiting the results of a Swedish pilot on prostate cancer screening which will be considered.
In January a leading urologist speaking on the Radio 4 Today Programme advocated all men over the age of 50 going to their GP for a PSA test or over the age of 45 if from a black ethnic minority or had a family history of the disease.
In February, an analysis by Prostate Cancer UK claimed the introduction of MRI before biopsy, as well as changes to the way biopsies are done, tipped the seesaw in favour of screening.
However, GPs and other experts warned that this push by charities for screening was ‘unhelpful’, and full evidence needs to be considered, and that current tests for prostate cancer do not reduce the number of men dying.
READERS' COMMENTS [4]
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Unfortunately, much as I like their resources, this is the charity ProstateCancerUK overreaching considerably and the comms people at the DHSC have swallowed it whole. As a 50+ year old man I did the screening test and it rates all over 50s as at higher risk of prostate cancer on age alone, inviting me to discuss it with my GP – other factors obviously increase the risk still further. No one over 50 can have a negative screen so PCUK really is asking all of the over 50s to get a test. Now I never say no to any man who asks, as long as they have a grasp of the grey areas they may be plunged into, but it is disingenuous of the charity and the DHSC to act in this way. I’m not sure the ends always justify the means – but if it’s your single issue, then who cares?
Just checked for me -no symptoms, or FH -aged over 50.
Says ” You are at higher risk of getting prostate cancer. Here’s why: As a man over 50 you are at a higher risk of getting prostate cancer than most men (really) , but it doesn’t mean you definitely will get it (reassuring?). Prostate cancer mainly affects men over 50, and your risk continues to increase as you get older. ” then goes on to tell me to discuss /get a PSA with your GP.
The problem with this is campaign is 1) not resourced 2) screening interval not stated so pts keep coming back randomly declaring their right 3) Not sure advice given is factually true either being pedantic. In my practice population there are more men 50-100, than 18-49. So I would be exactly the same risk of “most men” and possibly lower risk than people of my age with additional risk factors. Not against setting a properly resourced funded screening campaign like FIT /breast screening -but can’t just expect GP to pick up.
If marginal GP time is calculated as being worth £0 then any benefit / £0 means this campaign has infinite benefit! 😉
If we were still reliant on template biopsies, I would agree that random PSA testing is likely more trouble than it’s worth for most men, but now that we have parametric MRI, I really feel that the argument for a national screening programme is strong.