Question to the Department of Health and Social Care:
To ask His Majesty's Government following the joint statement released on 9 June by the British Association of Urological Surgeons and Prostate Cancer UK regarding the poor utility of the digital rectal examination as a test for prostate cancer, whether they will review the current clinical guidelines and referral criteria to remove “outdated” testing and ensure men at highest risk of prostate cancer can be diagnosed faster, fairer and better.
The Government is committed to ensuring that all patients with cancer, including prostate cancer, are diagnosed faster and with the best diagnostic approaches. The National Institute for Health and Care Excellence (NICE) is the independent body that develops authoritative, evidence-based guidance on best practice for health and social care professionals in England.
Current NICE guidance does not recommend digital rectal examination for diagnosing prostate cancer. NICE does recommend digital rectal examination as part of the physical examination that should be offered to all men with lower urinary tract symptoms as part of their initial assessment. If their prostate is assessed as likely malignant, they should be referred using a suspected cancer pathway referral for prostate cancer. To date, NICE has found no evidence that affects these recommendations or the need to review the current guidelines.
NICE is monitoring studies relating to the identification of prostate cancer in primary care and will consider the findings, when available, to assess if its recommendations need to be reviewed.
To further improve how we diagnose prostate cancer, the Government has invested £16 million in the United Kingdom-wide TRANSFORM trial, aimed at helping to find the best ways of detecting prostate cancer in men, even if they are not displaying any symptoms.
Furthermore, NHS England has introduced a best-practice timed pathway for prostate cancer so that those suspected of prostate cancer receive a multi-parametric magnetic resonance imaging scan first, which ensures that only those men most at risk of having cancer undergo an invasive biopsy. The AI in Health and Care Award has also been established, which aims to accelerate the testing and development of artificial intelligence (AI) technologies that align with the NHS Long Term Plan. £113 million has already allocated to support 86 AI technologies, and three of these projects specifically relate to prostate cancer, one of which is the Paige prostate cancer detection tool, developed by the University of Oxford.
We will also publish a new National Cancer Plan later this year, which will include further details on how we will improve diagnostics, access to treatments, and outcomes for all tumour types, including prostate cancer.