Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of a national prostate cancer screening programme on (a) early diagnosis rates and (b) health inequalities.

The Department is guided on screening policy by the UK National Screening Committee (UK NSC). The committee has commissioned a university to carry out a high quality review and cost effectiveness model of the evidence for a national prostate cancer screening programme. This includes targeted approaches to high risk groups and an offer to all men defined by age.

However, their previous review advised against screening because the current best test, the prostate specific antigen test, is not accurate. As a result, it can lead to some men receiving false reassurance when they do actually have prostate cancer, and others receiving unnecessary further tests when they did not have prostate cancer.

Black men are twice as likely as white men to get prostate cancer. But using an inaccurate test on this group of men might not reduce health inequalities. Instead, it risks leading to greater levels of misdiagnosis in this group. We need a better test, which is why the Government has invested £16 million in the TRANSFORM trial, to look for a better test. This trial will ensure that one in ten participants are black men.

Many prostate cancers are very slow growing and many men can live and die with prostate cancer, without ever showing any symptoms. Early diagnosis in prostate cancer can lead to unnecessary interventions and treatment that can have nasty and life altering side effects, for a cancer that would never have caused harm. That is why the UK NSC, when reviewing the evidence for a screening programme, must balance the benefits, including a reduction in mortality, against the harms. Only where the committee is confident that high quality evidence suggests a programme will do more good than harm will it be recommended.