New guidance from the Department of Health and Social Care could stop men over the age of 50 from being automatically entitled to a PSA test when they don’t have any symptoms. This blood test can detect prostate cancer even in the earliest stages when it rarely has any signs.
Change in testing rules
Before the update, men over the age of 50 could get a Prostate-specific Antigen (PSA) test through their GP just by asking, regardless of whether they had any symptoms. The new guidance allows GPs to have the final say on whether testing is appropriate, meaning men could have their requests denied if they don’t have symptoms.
There is currently no nationwide screening programme for the cancer despite it being the most common cancer among men in the UK. A report from the UK’s National Screening Committee earlier this year said nationwide prostate cancer screening would ‘cause more harm than good’ and recommended a targeted programme to only test men with the highest risk.
Charity criticism
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.”
Prostate cancer is usually slow-growing and rarely triggers symptoms in the earlier stages. As a result, some men may have the condition for years without knowing but early diagnosis can greatly improve treatment and outcomes.
Symptoms to watch for
Most prostate cancer symptoms affect the way you urinate, according to the NHS, this includes: finding it difficult to start peeing or straining to pee, having a weak flow of urine, "stop start" peeing, needing to pee urgently or often, or both, feeling like you still need to pee when you've just finished, and peeing during the night.
Other symptoms include erectile dysfunction, blood in urine or semen and lower back pain or losing weight without trying. Men who have these symptoms are urged to see their doctor.
NHS guidance notes: “These symptoms do not always mean you have prostate cancer. You can also get these symptoms if you have an enlarged prostate. This is a very common non-cancerous condition caused by the prostate getting larger as you get older.
“You might find you get used to some of these symptoms. But it's important to be checked by a GP if your symptoms change, get worse, or do not feel normal.”
Risk factors and response
A GP may suggest having a PSA blood test, which doesn’t directly test for the 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.
Being over the age of 50 can increase the risk of prostate cancer. Similarly, being from a Black African or African Caribbean ethnic background, having a history of prostate cancer in your family or close relatives with certain other cancers, particularly at a young age, are also risk factors.
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 Telegraph: “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.”
