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Prostate Cancer: Screening

Volume 464: debated on Friday 19 October 2007

To ask the Secretary of State for Health how many prostate specific antigen (PSA) tests were carried out by the national health service in 2006-07; how many men were diagnosed with prostate cancer as a result of the test; what alternatives to the PSA test have been assessed; what plans he has to introduce such alternative tests; and what discussions he has had with his counterpart in the Welsh Assembly Government on methods of prostate cancer diagnosis. (157978)

The prostate specific antigen (PSA) test measures the level of PSA in a man’s blood. However, it is not perfect. Some men with prostate cancer do not have raised levels of PSA. Two-thirds of men with raised levels of PSA, depending on the cut-off level used, do not have prostate cancer. The PSA test cannot distinguish between men with slow-growing prostate cancer and those who have a more aggressive disease.

The number of PSA tests carried out in the national health service is not held centrally. The Department policy research programme funded a study on urological referral in men with raised PSA levels and patterns of testing in general practice between 2002 and 2004. The study showed that the annual rate of testing is estimated to be 8.6 per 100 men 1.

The number of men diagnosed with prostate cancer as a result of having a PSA test is not held centrally. However, it is likely that most men with a diagnosis of prostate cancer had at least one PSA test as part of the diagnostic process.

The Government are committed to introducing a national screening programme for prostate cancer if and when screening and treatment techniques are sufficiently well developed. There is currently insufficient evidence from any country in the world to show that screening would reduce deaths from prostate cancer. The United Kingdom National Screening Committee (NSC) keeps screening for prostate cancer under review.

The Department is supporting the development of screening technology for prostate cancer by having a comprehensive research strategy into all aspects of prostate cancer. We are jointly with other National Cancer Research Institute (NCRI) members funding two NCRI Prostate Cancer Research Collaboratives, and the Department has funded half of the total £7.4 million cost for the first three years. Following a review of progress by an international expert panel the Department, Cancer Research UK and the Medical Research Council have agreed to provide a further three years funding of £3.9 million. The research undertaken by the Collaboratives covers all aspects of prostate cancer, and the NSC will be kept closely informed of any research results affecting the evidence base of prostate cancer screening. We are also monitoring international trials on prostate cancer screening.

It is important to note that in order for a screening technology to contribute to saving lives it is essential for there to be effective treatments for the disease detected. That is why the Department is funding a £20 million trial of treatments for (PSA) screen-detected early prostate cancer (the ProtecT trial). The trial is due to complete in 2008.

Regarding the Welsh Assembly, the Director of Cancer Services at NHS Wales is an observer on the Department’s Prostate Cancer Advisory Group.

1 This is estimated data from selected general practitioners (GPs) at four laboratories and does not represent the whole of England. Only GP requests for PSA testing were included in the study, not those from urology departments. The study did not include testing undertaken in the independent sector. The study was restricted to men aged 45 to 84 years.