Introduction to Prostate Cancer Screening
The UK 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.
What is Screening?
Screening involves inviting people for a test to check for illness even though they have no symptoms. Examples include women being invited for a mammogram to screen for breast cancer, or the home colon cancer test that is sent to your home every two years starting at age 50. The idea is to detect cancer before someone gets sick and it is still treatable.
Recommendation for Prostate Cancer Screening
Experts say there is no justification for screening the vast majority of men for prostate cancer. They examined all available evidence and concluded that screening was only suitable for men at genetic risk for prostate cancer, specifically those with confirmed BRCA gene variant. This group should be screened every two years between the ages of 45 and 61.
Why Not Screen All High-Risk Men?
Many predicted that all men at high risk of disease would likely be included in new screening plans. However, the committee fell short of this recommendation. Although black men are twice as likely to develop prostate cancer, there should be no screening for black men because of “uncertainties” about the impact and a lack of evidence from clinical trials in these men. For the same reason, it was also recommended not to screen men with a family history of the disease – too many cancers would be overdiagnosed and overtreated.
Why the Committee Came to This Conclusion
Britain’s National Screening Committee said a mass screening program for prostate cancer would likely do more harm than good. Tests for the disease are unreliable and can result in men being treated for a slow-growing cancer that won’t harm them. The treatment itself can lead to incontinence and impotence, which can significantly affect the quality of life. In return, early detection and treatment of cancer can save lives. But it’s difficult for doctors to figure out which cancers are aggressive and spreading, meaning men need to be treated unnecessarily.
Testing for the BRCA Variant
A genetic test is required that looks for a mutation in the BRCA-1 and BRCA-2 genes. These gene variants can affect men and women and increase the risk of a number of cancers, including prostate, breast and ovarian cancer. About three in 1,000 men have BRCA variants, but many will not know it unless they have family members known to be carriers and then have it confirmed by a test.
Prostate Cancer Statistics
Prostate cancer is the most common cancer in men. Around 55,000 men are diagnosed with the disease every year and 12,000 men die from it in the UK every year.
Is This the Final Word on Screening?
No, a three-month consultation on the recommendations begins now. The committee will then meet again and give its final advice to ministers. They must then make their individual decision about prostate screening. The health secretary says he wants to carry out screening, but only if it is “backed by evidence”. He said he would consider the evidence “thoroughly” before making his final decision.
