Prostate Cancer

Lord Mott Excerpts

Wednesday 3rd September 2025 Lords Chamber

Asked by

[Lord Mott]

To ask His Majesty’s Government what steps they are taking to ensure that GPs proactively discuss prostate cancer with men at the highest risk; and inform them of their right to a free prostate specific antigen test.

[Lord Mott (Con)]

My Lords, around one in eight men will be diagnosed with prostate cancer at some point in their lives. In the UK, it is the most commonly diagnosed cancer in men and, sadly, it causes around 12,000 deaths a year. Even more tragically, this number includes many men who are dying needlessly due to late diagnosis. Around one in five of those diagnosed are diagnosed too late. When caught early, there is nearly a 100% survival rate—a remarkable reflection of advances in treatment—but survivability plummets to around 50% when the cancer has progressed to stage 4. Our current approach to testing and screening is falling short. That is why I have secured this debate today, and I welcome Members from across the House who have indicated that they wish to take part.

I support calls for a targeted screening programme for high-risk men. I believe that over 135 Members in the other place have expressed their support, as have many noble Lords. Importantly, so have the vast majority of GPs when surveyed, as well as many patient and campaign groups, including Prostate Cancer Research and Prostate Cancer UK, which I must thank for their support. It is also important to thank the Daily Telegraph and Daily Mail for raising awareness by taking up the campaign.

The National Screening Committee is currently carrying out its review, but it seems clear to me that the introduction of MRI and new biopsy techniques, alongside the traditional PSA test, goes a long way to addressing concerns about the accuracy of a PSA test alone and the risks of the diagnostic process. The All-Party Parliamentary Group on Prostate Cancer published a report yesterday to that effect, highlighting the progress that has been made in reducing the risk of overdiagnosis and overtreatment. I hope the noble Baroness, Lady Merron, can offer an update on when this is expected to conclude and on what the Government are doing to ensure there is no further delay.

I also want to note the longer-term work, including the £42 million TRANSFORM trial, announced under the previous Government, that can further add to the evidence base and is a huge step forward; yet I have not chosen to make this the focus of today’s debate, because the issue is too urgent to wait. I want to focus on what we can do immediately to stop men dying needlessly.

Whatever the outcome of the National Screening Committee’s review, we need to change the guidance we give to GPs. At the moment, we leave it to men to proactively request a PSA test from their doctor and we actually prevent GPs from raising the issue, even with men who are at the highest risk. Men are already more likely to put off a visit to the doctor. I must admit I know this from personal experience. How realistic is it to have a system that means a man must proactively find out his risk and then chase his doctor for a prostate cancer test? It means only those who have sharp elbows or who are highly skilled at navigating the health system are getting the tests they need. It is bad enough across the board, but such an approach also entrenches health inequalities, leaving high-risk groups, particularly black men, those with family history and men in deprived areas, seriously disadvantaged.

This guidance was well intentioned when drafted, but it is now out of date. Previously, the test used could cause pain and bleeding and came with a risk of serious infection, but the introduction of MRI and new biopsy techniques has been transformational. Diagnosing prostate cancer has never been safer or more accurate. When combined with the serious consequences of late diagnosis, an update to the guidance is justified. Allowing GPs to have proactive discussions with high-risk men about their right to a free PSA test does not mean that everyone will choose to have a test; indeed, allowing doctors to have proactive conversations could help to reduce the overall proportion of over- diagnosis and overtreatment. GPs would only be proactively raising the point with those most likely to be diagnosed with aggressive cancers.

If we want to say we have a policy of informed choice, then let us make that a reality. Do not leave men to have to do their own research. Let their GPs talk them through it, let GPs guide men on the risks and benefits, and let us make the system one that does not entrench health inequalities. Will the Minister give a commitment today to revisit the guidance given to GPs through the prostate cancer risk management programme to allow them to have proactive conversations with high-risk men?

In conclusion, there is much more to do to stop men dying needlessly of prostate cancer that goes well beyond the scope of this debate, from supporting research and investing in our diagnostic infrastructure to outreach through efforts like the “Man Van” model, which recently made an appearance in Westminster, and the excellent work that has been carried out by Professor Stephen Langley at the NHS Royal Surrey cancer centre and hospital in Guildford, with a trial run by Surrey and Sussex NHS cancer alliance. I certainly hope that we have a targeted national prostate cancer screening programme once the National Screening Committee completes its review. Irrespective of the committee’s decision, we can take action today to end the absurd practice of GPs being prevented from raising prostate cancer checks with men at the highest risk. I urge the Government to take this forward without delay and I look forward to the debate and to hearing from the Minister.