Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether the UK National Screening Committee’s modelling assumes that the introduction of a prostate cancer screening programme would be additional to, or would partially replace, existing opportunistic PSA testing in primary care.

Drawing on the available peer reviewed evidence, the Sheffield Centre for Health and Related Research (SCHARR) has undertaken economic analysis on behalf of the UK National Screening Committee.

In their modelling, in line with best practice and the standard academic approach to assessing a new screening proposal, the SCHARR team has included the best available information on current care and compared this to a number of possible scenarios for a new prostate cancer screening programme. This includes the best estimate of current opportunistic prostate-specific antigen (PSA) testing.

There is little published data available that can determine between PSAs sought by asymptomatic males at their general practices (GPs), opportunistic PSA testing, and other types of PSAs in use which can include testing for symptomatic males where this could support a diagnosis and for men who are on a range of treatment pathways for known prostate cancer.

A prostate cancer screening programme would be most likely to add to the number of PSA tests because GPs have the right to offer a PSA test in line with their clinical judgement and this would continue outside of any screening programme. This is consistent with other screening programmes including, for example, access to the faecal immunochemical tests outside of the NHS Bowel Cancer Screening Programme.

The risk of overdiagnosis identified in the SCHARR model is in line with other international evidence-based prostate screening models which have been developed by academics in line with standard academic approaches and are underpinned by high quality published evidence.

New data on PSA uptake was published after the completion of the modelling report and will be incorporated into further model iterations before the completion of the consultation period.