Issue - meetings

Dr Guy Hayhurst, Consultant in Public Health, to discuss prostate cancer screening and awareness.

Dr Guy Hayhurst addressed the Committee in relation to prostate cancer.  The National Screening Committee had advised since 1997 against the implementation of a routine screening programme for prostate cancer.  If a test was undertaken (PSA test) on men without symptoms, it carried the risk of detecting non-significant disease in healthy men.  This could result in follow up investigations and treatments which were invasive and could cause harm without providing any benefits.   Approximately two out of three men with a raised PSA level would not have prostate cancer.  The PSA test was not a diagnostic test and would usually be undertaken alongside other examinations by a GP who would work with the local acute hospital if necessary.

If tests were conducted on men in their 50s it was likely that a low grade form of prostate cancer would be found in most of the men; however, this would not require any treatment unless the men were also symptomatic.  Dr Hayhurst explained that many men could have prostate cancer for decades without it causing them any problems and in those cases it was best left alone with treatment reserved for men with symptoms. 

Although routine screening of healthy people without symptoms was carried out for detection of some cancers, it was not appropriate for prostate cancer.  It was recommended that testing was only done where the man had symptoms which would suggest the cancer was spreading and therefore harmful. 

Dr Hayhurst referred to a medical trial in America looking at the long term outcomes of men who had taken a PSA test; of those who had a raised level half received treatment and half the men did not.  After 12 years there was no difference between the two groups in terms of mortality rates. 

In discussing the presentation, Members raised the following points:

·        There was an important role in raising awareness of prostate cancer including making men aware of the symptoms and the need to see their GP if they had symptoms;

·        That men over 50 in prison were routinely offered PSA tests;

·        Whether there were any National Institute of Health and Clinical Excellence (NICE) guidelines around prostate cancer screening?  In response, Members were advised that there were well established guidelines for treatment.  Representatives of NICE were due to meet with prostate cancer charities in October to assist with a NICE review of treatment and therapies for prostate cancers that had arisen following investigation of symptoms.

RESOLVED: that the update be noted.