what you need to know
Getty ImagesThe UK’s National Screening Committee has recommended that only a very small group of men at high risk of prostate cancer should be screened for the disease.
There is currently no screening program for prostate cancer, the most common cancer in men.
But high-profile figures have campaigned vigorously for change, including Sir Chris Hoy, who has terminal prostate cancer, and Lord David Cameron, who recently revealed he had been treated for the cancer.
The experts’ opinions will now be consulted over the next three months, before the selection committee gives its final recommendations to the governments of the four UK countries in March.
What is screening?
Screening involves inviting people to take a test to look for a disease even if they have no symptoms.
Examples include women being asked to have a mammogram to check for breast cancer or the home bowel cancer screening test that is posted to your home every two years after age 50.
The idea is to catch cancer before a person starts getting sick and when it can still be treated.
What was recommended today?
Experts say there is no reason to screen the vast majority of men for prostate cancer.
They reviewed all available evidence and concluded that screening is only suitable for:
- men at genetic risk for prostate cancer (with a confirmed BRCA gene variant)
The advisory says this group should be screened every two years between the ages of 45 and 61.
This means that no screening is recommended for other high-risk groups of men such as:
- black men
- men with a family history of prostate cancer
Why did they come to this conclusion?
The UK’s National Screening Committee has said a mass screening program for prostate cancer is likely to cause more harm than good.
Tests for the disease are unreliable and can lead to men being treated for a slow-growing cancer that will not harm them. The treatment itself can cause incontinence and impotence, which can significantly affect quality of life.
On the other hand, early detection of cancers and their treatment can save lives. But it’s difficult for doctors to determine which cancers will be aggressive and spread, meaning men may be treated unnecessarily.
The committee said the number of lives saved through screening does not exceed its harmful effects on healthy men.
Why not screen all men at high risk?
Many predicted that all men at high risk of the disease would likely be included in the new screening plans.
But the committee did not act on this recommendation.
Although black men are twice as likely to develop prostate cancer, the report believes there should be no screening in black men due to “uncertainties” about its impact and a lack of evidence from clinical trials in these men.
He also recommends not screening men with a family history of the disease, for the same reason: too many cancers would be overdiagnosed and overtreated.
But men with specific genetic mutations – called BRCA variants – develop aggressive, faster-growing cancers earlier, warranting their screening.
Treating these cancers earlier is more likely to benefit these men and offset potential harm from unnecessary treatment, compared to men in the general population, experts said.
How to test for the BRCA variant?
A genetic test is necessary to look for a mutation in the BRCA 1 and 2 genes.
These genetic variants can affect both men and women, increasing the risk of various cancers, including prostate, breast and ovarian cancer.
About three in 1,000 men carry BRCA variants, but many won’t know it unless they have family members who are known carriers and then have them confirmed with a test.
Experts say that in the future, more genetic testing will need to be offered to high-risk men, to determine how many of them are affected.
How many men have prostate cancer?
Prostate cancer is the most common cancer among men.
Around 55,000 men are diagnosed with the disease each year and 12,000 men die from it each year in the UK.
Is this the last word on screening?
No, a three-month consultation on the recommendations begins today.
The committee will then meet again and give its final advice to ministers from England, Wales, Northern Ireland and Scotland.
They will then have to make their own decision about prostate screening.
Wes Streeting, England’s health secretary, says he wants testing to be implemented, but only if it is “supported by evidence”.
He said he would review the evidence “thoroughly” before making his final decision in March.
