Prostate Cancer Screening Debate
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Stuart Anderson
Main Page: Stuart Anderson (Conservative - South Shropshire)Department Debates - View all Stuart Anderson's debates with the Department of Health and Social Care
Prostate Cancer Screening
Stuart Anderson Excerpts(3 days, 15 hours ago)
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John Lamont
The hon. Member is right. There is so much work and research going on in this area, and it is imperative that the Government acknowledge that work and react once more informed evidence becomes available.
The petitioners argue that the UK NSC has “fixated on potential harms” and underweighted the benefits of earlier detection, but there are good reasons why screening programmes face a higher evidential threshold. A raised PSA level does not by itself diagnose prostate cancer, but can cause anxiety and lead to further investigation. Screening can also result in overdiagnosis and unnecessary treatment, which can cause lasting harms. Prostate Cancer Research challenged the draft modelling, arguing that it relied too heavily on older evidence and did not adequately reflect modern MRI-led diagnostic pathways. The UK NSC says it considered those criticisms and updated its modelling before reaching its final recommendation.
Stuart Anderson (South Shropshire) (Con)
I thank all my constituents who have contacted me about this vital point. Community diagnostic centres offer great resources to speed up screening. Does my hon. Friend agree that more emphasis should be put on those centres, particularly in rural areas like South Shropshire?
John Lamont
My hon. Friend makes a crucial point about the importance of testing centres being available in rural areas, and about how community-based testing centres link into the NHS and the research that is being carried out.
There remains significant disagreement about the scale of harm. The UK National Screening Committee estimates that for every 1,000 men offered screening, up to 20 could be overdiagnosed, while around two lives are extended. Analysis by Prostate Cancer Research of more contemporary, MRI-led studies estimates that, roughly, for every two lives saved, three men are overdiagnosed. The updated Cochrane review published in May found that for every 1,000 men screened, PSA-based screening is likely to reduce prostate cancer mortality by around two deaths, while questions about overdiagnosis and treatment-related harms remain.
When I met researchers from the Transform team, they highlighted an important nuance: MRI has reduced unnecessary biopsies, but it has not yet been shown that those diagnostic advances sufficiently reduce overtreatment. Questions also remain about how organised screening would interact with the PSA testing that is already taking place, and about screening black men, with the UK NSC saying it has insufficient evidence to determine
“whether screening would cause more good than harm.”