Men over the age of 50 may only be able to get a vital blood test for prostate cancer once they are already showing symptoms, according to a letter from an unnamed official at the Department of Health and Social Care. Being over 50 is a risk factor for prostate cancer, which rarely shows symptoms in the earliest stages. While there is no national screening programme for the cancer, men with symptoms can ask their GP for a PSA blood test, which can indicate if something is wrong with their prostate.
New guidance puts final say in GPs' hands
The government confirms that the policy hasn't changed and that men can still approach a GP, but the final call on testing is now entirely in the hands of the doctors. Rules remain unchanged for men showing potential symptoms of prostate disease, who will still be referred for testing.
New guidance from the Department of Health and Social Care states that it is now up to the GP whether this test is appropriate by considering the patient's risk and laying out the pros and cons of the test, unless the patient is at high risk or showing symptoms. According to the letter, as reported by the Telegraph, men over the age of 50 are no longer considered at high risk by this factor alone.
Department defends updated guidance
A spokesperson for the department said the previous guidance was “retired” because it was deemed ambiguous and that it was always the intention for the final decision to lie with GPs on whether the test should be administered. They told the outlet: “Every man still has the right to ask their GP for a PSA test, and it remains the case that the final decision rests with GPs. All this letter does is tell GPs and others where to find the most up-to-date guidance.”
A Prostate-specific Antigen (PSA) test doesn't directly test for cancer, but can indicate if there's an issue with your prostate. If your PSA test comes back higher than normal, you may be offered further tests to narrow down the cause, which can be prostate cancer or other less serious issues like a prostate infection.
Charity and political backlash
David James, director of patient projects and influencing at charity Prostate Cancer Research, told the Telegraph: “This is a shocking betrayal and backward step that will condemn thousands more men each year to a late and incurable diagnosis.” Former Prime Minister Lord Cameron, who has been treated for prostate cancer, agreed it was a "backwards step", telling the outlet: "I urge the new Prime Minister and Health Secretary to be brave and bold. Stop the complexity and confusion and introduce a more progressive and life-saving policy: a proper, targeted screening programme that involves all those at higher risk."
Earlier this year, a report from the UK's National Screening Committee said nationwide prostate cancer screening would 'cause more harm than good' and recommended a targeted programme to only test men with the highest risk. While prostate cancer can be deadly, some grow so slowly that patients would need to reach 120 to 150 years old before it becomes a threat. The UKNSC noted that with a national screening programme, men could face this diagnosis that won't need treatment but could still take a mental toll according to the BBC. Additionally, doctors aren't always able to tell which prostate cancers need treatment and which aren't a threat, meaning some men with these slow-growing cancers may end up having unnecessary treatment and facing lifelong consequences as a result.
Prostate cancer treatment can cause some chronic health issues including leaking urine, erectile problems and bowel problems. Mental health issues have also been reported such as anxiety.
