Prostate Cancer

Lord Patel Excerpts

Wednesday 3rd September 2025 Lords Chamber

[Lord Patel (CB)]

My Lords, I thank the noble Lord, Lord Mott, for initiating this debate. Some of my comments are shared by the noble Lord, Lord Winston, on whose behalf I also make them, as he is in hospital with a broken leg—but he is doing okay.

I agree with the comments that the noble Lord, Lord Mott, made about identifying and offering the PSA test for higher-risk patients. My comments are therefore not about GPs’ role in offering the test to men at higher risk of prostate cancer. My comment is mostly based on the use of PSA as a test for screening purposes. It is a test which has a fairly high degree of sensitivity but a very low degree of specificity, which means that the rate of false positives and false negatives is very high for a screening test.

I agree that some of the trials being carried out—the noble Lord, Lord Mott, mentioned one in Royal Surrey hospital, and there are others in Europe and the United Kingdom—may help us modify the guidance that could be given based on the results of the study and therefore could be targeted at a wider group of people. But we need a test that is much more reliable, easily carried out and much more accurate. Such a test as a preliminary study was developed by the Institute of Cancer Research and the Royal Marsden Hospital. It uses a spit test, which recognises 130 different modifications or mutations of DNA with a high degree of specificity, much higher than the PSA, and a high degree of sensitivity. In a model trial, it would have identified nearly 13,000 patients, the same number of deaths that occur per year, with low-grade prostate cancer. It is a test that requires further trials, because it is easily administered and may become part of a wider screening programme. So we need to be much more aware of innovations that may occur.