Charity Blasts Prostate Cancer Guidance

A leading prostate cancer charity has criticised advice not to roll out a national screening programme.

The UK National Screening Committee (UKNSC) said only “a few thousand” high-risk men in the UK should be tested for prostate cancer.

In a statement issued today (Friday) men’s health charity CHAPS said the guidance flies in the face of the evidence.

CHAPS has carried out PSA testing for around 12,000 men across the UK. 

According to the charity’s data, approximately eight per cent receive abnormal results requiring further investigation.

Professor Chris Booth, medical director of CHAPS, said: “Prostate cancer (PCa) is the most common cancer in UK men, yet its death rate continues to rise and remains one of the worst in Europe.

“National progress in addressing this issue has been persistently stifled by the UK National Screening Committee (NSC). Its latest recommendation, that screening should be limited to men with rare BRCA gene variants, flies in the face of the latest evidence, which clearly demonstrates that the benefits of screening, namely the detection and cure of potentially lethal cancers that now kill an estimated 13,000 UK men annually, outweigh the harms.

“These so-called “harms” relate to the identification and overtreatment of non-aggressive prostate cancers, potentially resulting in side effects such as incontinence and impotence.

“UK National Prostate Cancer Audits confirm that, since the introduction of game-changing MRI scanning into the diagnostic pathway, overdiagnosis of non-aggressive prostate cancer has been greatly reduced. Overtreatment rates in the UK have consistently remained below 10%.

“CHAPS screening statistics further confirm that 80% of the cancers diagnosed through screening require radical, curative treatment. These findings have been replicated across all UK screening programmes reported at the CHAPS National Prostate Cancer Screening Conference in London in March, a conference to which the NSC was invited but failed to attend. Why, then, has the NSC and UK policy got this so wrong?

“Across Europe, the European Parliament has recommended prostate cancer screening on the basis of evidence provided directly by the European Association of Urology, arguably the world’s most respected authority on the subject. Major screening projects are now being completed in five EU countries, with additional programmes due to commence this autumn.

“By contrast, the UK NSC has based its recommendations on a deeply flawed report produced by an academic department in Sheffield that had negligible expert urological input. This SCHARR report has since been independently scrutinised by the York Health Economics Consortium and described as “not fit for purpose”.

“The NSC itself has no specific urological expertise and appears disconnected from mainstream urological practice. The consequence is that this introspective committee continues to stifle progress in tackling one of the most serious cancers affecting UK men, along with the needless suffering and deaths it causes.

“Contrast this with Sweden, which has a similar national health service and no national prostate cancer screening programme. However, Swedish health regions are encouraged to implement organised screening schemes into which men can voluntarily enrol. Unsurprisingly, Sweden is reporting substantial reductions in prostate cancer mortality among screened men compared with those who remain unscreened.

“My conclusion is that the NSC and its impractical recommendations should be sidelined, if not scrapped altogether.

Public pressure must continue, and politicians and policymakers should base decisions on the evidence emerging from our own home-grown data. Above all, they must empower urologists, the true experts in this field, to implement a progressive screening programme that allows men, particularly those at increased risk, to enrol voluntarily.

“Only then will we begin to address the appalling inequity in access to screening, diagnosis and expertise for the UK’s most common cancer, and the only major cancer for which no national screening programme currently exists.

Earlier this year CHAPS warned the UK risks falling further behind Europe on prostate cancer survival rates without the introduction of a national screening programme. 

The warning was issued at the charity’s 2nd National Conference on Prostate Cancer Screening in London.

For more information about CHAPS visit https://chaps.uk.com/about-us