Health: Cancer

Lord Kinnock Excerpts

Thursday 11th November 2010 Lords Chamber

[Lord Kinnock]

My Lords, I naturally join the noble Viscount, Lord Bridgeman, in thanking the ever-vigilant, ceaselessly campaigning and profoundly knowledgeable noble Baroness, Lady Finlay of Llandaff, for initiating this debate. In my contribution, I want to focus on the need for improved measures of information, advocacy and treatment relating specifically to prostate cancer.

In the UK, around 36,000 men are diagnosed with prostate cancer every year, making it the most common cancer in men. More than 10,000 men die each year from the disease—about 12 per cent of the total number of men killed by cancer. Only the rates of lung cancer exceed those figures among men. Prostate cancer mortality rates have remained almost constant for the past 20 years in the United Kingdom.

Against that background, I offer the argument that this major killer, which on average takes the life of more than one man every hour, should be a high-priority target of policy-makers and medical practitioners, as it is a disease which, if diagnosed early, can be very effectively treated and even cured in many cases. The requirement of early diagnosis is therefore vital. To fulfil it properly, however, several barriers of ignorance and cultural diffidence have to be dismantled, advances have to be made in the knowledge and practices of general practitioners, as my noble friend Lady Royall has emphasised on previous occasions, and far stronger efforts must be made to implement policies which have been approved by successive Governments but have not been applied with the necessary vigour.

The need for the first development—combating public ignorance—is graphically illustrated by the fact that, while at least 10,000 families, neighbours and workforces every year suffer the loss of a male relative or friend, seven out of 10 adults do not know what the prostate gland is or what it does. Forty-six per cent of respondents to a reputable survey earlier this year were unaware of the prevalence of prostate cancer. The same survey also showed that 70 per cent of the men questioned were not aware of the existence of the prostate specific antigen blood test, which so far is the only easily administered test that can identify a prostate abnormality and, helpfully and indicatively but not unerringly and conclusively, show the presence of cancer.

As a result of these factors, the simplest of measures to improve the quantity of life of men with prostate cancer would be hugely to increase printed and broadcast publicity about the nature and incidence of the disease, the need for the earliest possible diagnosis and treatment, the existence and the limitations of the PSA test and the right of men—recognised and accepted by the current and previous Governments—to make an informed choice about whether to have a PSA test, and to get the test on the National Health Service if they want it.

That established entitlement to make an informed choice is crucial. Indeed, I would make the argument that the full and effective exercise of that right requires the introduction of a national programme of screening that is comparable with the programmes for detecting breast, cervical and bowel cancer. The National Screening Committee has, I know, been consulting on this matter, and I would be grateful if the Minister could now say what, if any, conclusion has been reached on those consultations. I would also like the Minister to respond to the following questions.

First, it is now three years since the Department of Health’s cancer reform strategy recognised the need to explore new approaches to improving the information about prostate cancer and the PSA test. No new approaches have been introduced or even piloted. I would like to know whether action is going to be taken.

Secondly, the Government’s worthy and continuing policy—explicitly expressed by the Chief Medical Officer in July 2009—of recognising men’s right to make a universally informed choice about having a PSA test, and to be tested on the NHS if they want it, is commendable. However, that policy must be embraced by the cancer reform strategy, supported by much more resonant and widespread publicity, and communicated more directly and rigorously to general practitioners.

Finally, I emphasise the irreplaceable role of GPs in achieving improved knowledge about the diagnosis and treatment of prostate cancer. But I also underline the need to deepen and widen the awareness of GPs—a need which is made emphatic by the following survey results. 75 per cent of the 250 GPs surveyed by the Prostate Cancer Charity this year were not aware of government guidelines for delivering information to men about the PSA test. 75 per cent of those surveyed said they never or only occasionally had unprompted discussion about the PSA test with asymptomatic men aged 50 to 70. 15 per cent of the surveyed GPs said that they do not support the right of asymptomatic men to have access to the PSA, even if requested by the patient on the basis of an informed decision. These findings are cause for concern. I do ask the Government, forcefully, to take their responsibilities seriously, to implement their policies and to secure a new level of awareness and action, particularly among GPs.