Prostate cancer screening
3.27 Every year around 19,000 men are diagnosed with prostate cancer in England and Wales and around 8,500 men die from it, typically around four to five years after diagnosis. It accounts for around 4% of all male deaths each year.
3.28 There is still a lot we do not know about prostate cancer. The NHS Prostate Cancer Programme sets out the background to the disease and the action that will be taken. Prostate cancer behaves in different ways in different men. Some cancers grow very slowly, others grow quickly. In some men the cancer is diagnosed only when they start to suffer symptoms from the spread of the cancer, usually in the bone.
3.29 There are no known primary prevention measures that men can take to minimise the risk of developing prostate cancer. This, along with the unknown causes of the cancer, highlights that there is a need for further research in this area to help our understanding of the progression of this disease.
3.30 Men with prostate cancer tend to have levels of Prostate Specific Antigen (PSA) in their blood that are higher than normal, though this threshold is subject to some discussion. But some men who have prostate cancer do not have raised levels of PSA and two thirds of men who have raised levels of PSA do not have prostate cancer.
3.31 To help men understand the basis of the PSA test, the consequences of a positive result and the options for treating prostate cancer, the National Screening Committee will introduce a prostate cancer risk management programme in 2001. The key elements of this will be:
- Informed choice - developing an education programme about prostate cancer for the public, patients and professionals, in particular the risks associated with PSA testing, using written material and videos
- A standardised test - ensuring that PSA testing is provided to an explicit quality standard
- Systematic and standardised follow up - developing an evidence based pathway for men whose PSA levels are above the threshold.
3.32 Results from a European randomised study of screening for prostate cancer will give an indication of whether population screening for prostate cancer is effective in reducing mortality rates. British researchers have recently submitted a proposal for a further prostate cancer screening trial to the Medical Research Council (MRC). Should the MRC decide to support the proposal, the Department of Health will provide substantial funding for it.
3.33 A prostate cancer screening programme will be introduced if and when screening and treatment techniques have developed sufficiently. The evidence to support the introduction of a screening programme will be kept under careful review by the National Screening Committee.
