Former UK Prime Minister Rishi Singh has called for a targeted program of prostate cancer screening for men at highest risk, reviving a national debate on easy methods to save more lives amongst men and tackle health inequalities.
The project, supported by Prostate Cancer Research, will provide regular screening for men aged 45 to 69, particularly those of Afro-Caribbean descent or with a family history of the disease.
Prostate cancer screening matters
Prostate cancer is probably the most common cancer in men within the UK, greater than 63,000 new cases per year. But big differences remain in who gets diagnosed, how early it's caught and who survives, reflecting differences in race, region and access to health care.
Afro-Caribbean men are twice as prone to develop the disease and more prone to die from it than white men. The risk can be higher for a father or brother who has had prostate cancer. These differences aren’t purely biological – in addition they reflect differences in awareness, access to care and trust within the health system. A targeted screening program can begin to shut this gap.
The screening process will begin with a PSA (prostate-specific antigen) test, which detects the concentration of a protein produced by the prostate gland. If the PSA level is higher than expected, it will trigger a step-by-step diagnostic process, including an MRI scan to enhance accuracy and, when mandatory, a biopsy to verify the diagnosis.
Recent improvements in imaging technology help doctors distinguish aggressive prostate cancer from less aggressive with greater accuracy, making modern screening more precise than it was ten years ago.
Early detection could be very vital in prostate cancer, because it is with many other cancers. Prostate cancer often develops silently for years before any symptoms appear. By the time it’s seen, it has already spread beyond the prostate gland.
At this stage, treatments similar to hormone therapy or chemotherapy may help control the cancer, even though it isn’t curable. Prostate cancer will likely be less invasive and more effectively treatable through targeted screening before it’s detected, offering a much higher likelihood of a full recovery.
Importantly, this proposal recognizes the necessity for greater inclusion in men's health. Afro-Caribbean men and people living in deprived areas are sometimes under-represented in clinical research, contributing to gaps in understanding and poorer outcomes.
A screening model based on scientific evidence and community engagement may help close this gap. It may also encourage young men, especially those of their 40s, to take a more lively interest in preventive health, replacing fear and stigma with informed confidence.
The proposed program, valued at $25 million per 12 months (approx.) per patient per patientwould likely be cheaper than many national screening initiatives while offering transformative advantages.
In particular, survival rates are significantly lower for men in Scotland, in addition to within the North West, West Midlands and Wales, indicating persistent geographic inequality. Prostate cancer diagnosis. Beyond early diagnosis, this proposal could foster trust and participation amongst underserved groups, stimulate biobank research to raised understand racial and genetic risk, and ultimately set a precedent for equity-driven preventive health care.
A national targeted PSA screening program will save lives and show that every one men, no matter background or postcode, deserve the identical opportunity for early detection.
Sussex Photographer/Shutterstock.com
The case against prostate cancer screening
Men should see their doctor often to care for their health and spot problems early. If caught in time, serious diseases like heart disease, diabetes and a few cancers could be controlled or completely prevented. But men don't all the time care for their health in addition to women do.
One in five Stop going to the doctor or getting tested. This is actually because they feel embarrassed, awkward or anxious about what other people might think, especially in the case of intimate health issues. By the time men finally get help, their problems are more severe and difficult to repair. This is particularly true for prostate problems and prostate cancer.
A test called the PSA test has been really useful as a straightforward solution to screen for prostate cancer. A single blood test can easily be included in a routine health check-up. Women have already got screening programs for breast and cervical cancer which have been in place for years and save 1000’s of lives annually by catching cancer early. So on the face of it, doing an analogous blood test for prostate cancer in men looks as if an obvious good idea.
But here's the issue. The PSA test is just not as reliable because the tests for breast and cervical cancer. Whereas breast cancer tests have “sensitivity” (the power to accurately detect cancer). Between 50-91%the PSA test has a A sensitivity of about 20% At a normal PSA cutoff of -4ng/ml. Things like an enlarged prostate, infection, and even recent exercise may give false results and make it seem like someone has cancer after they don't.
This distrust causes many problems. A high PSA result triggers a complete chain of tests and investigations into the prostate, a few of which could be invasive, painful and painful. These investigations themselves could cause unnecessary distress and put men vulnerable to harm. Men could be anxious and stressed for no good reason.
Another problem is that some prostate cancers can develop very slowly Never actually hurt An individual during his lifetime. They may require careful remark relatively than aggressive treatment. But when tests give “false positives” — saying someone has cancer after they don't — each means more investigation is required. This puts pressure on doctors, radiologists and other specialists who’re already stretched thin.
If someone is diagnosed with prostate cancer and undergoes surgery or radiation treatment, it will probably result in serious unintended effects similar to lack of bladder control, erectile dysfunction and serious psychological stress. Research shows Most prostate cancer Grow slowly and aren’t life-threatening.
The PSA test can be unreliable in the opposite direction. Some men who even have prostate cancer may get a traditional result and never be properly screened after they must have been.
Looking at the larger picture, studies show that PSA screening is barely preventative Three deaths from prostate cancer were experienced out of every 1,000 men. But this results in unnecessary diagnosis and intervention Up to 60 out of a thousand. It has done more harm than good.
From an NHS perspective, organising a nationwide PSA screening program can be too expensive and disruptive. Experts predict that it will increase the variety of tests and scans required About 23%.
It would mean 1000’s more appointments, more specialist doctors and staff, and loads of money spent on scanners and lab work – every thing the NHS is already struggling to offer. This additional workload can mean less money and time for patients who urgently need assistance with other cancers or serious illnesses.
The real answer isn't simply to screen more men for prostate cancer. This is a greater test to seek out. Men should definitely pay more attention to their very own health, but until now we have a test that may tell the difference between prostate cancer that can truly threaten someone's life and people who won't, the nationwide PSA screening program will do more harm than good.
It will turn healthy men into patients, overburden hospitals, and probably not give people clear answers. What we actually need is a test that finds the best cancer, at the best time, using the best tool — in other words, a greater test.