NHS scheme to let men request their OWN blood tests for prostate cancer ‘should be scrapped’

An on-demand blood test for prostate cancer should be scrapped because experts say it is harmful to men.

Men in the UK over the age of 50 can get a ‘blood test on demand’ through the NHS, after consulting their GP.

This test looks for a protein made by the prostate gland called prostate-specific antigen (PSA), which may be higher in men with cancer.

But experts want this approach scrapped because men who can request a PSA test are at risk of undergoing unnecessary treatments, such as prostate surgery, which can lead to lifelong incontinence and erectile dysfunction.

That risk is especially high for men over 70 who are diagnosed with prostate cancer after requesting a PSA test, according to an article in the British Medical Journal.

Most of these men might have been better off left undiagnosed and untreated.

They are old enough to spend their years with prostate cancer, if it isn’t aggressive, since tumors would never get big enough to cause disease.

The international experts therefore recommend scrapping the test-on-demand system.

Instead, they suggest prostate cancer screening for healthy men — similar to mammograms for healthy women that monitor their breast cancer risk.

In this scenario, with PSA testing in a nationwide population survey, only men ages 50 to 70 would get the blood test.

The only exception would be a small number of high-risk men over the age of 70, such as those with a family history of prostate cancer or a genetic mutation in the BRCA gene that increases the risk of developing prostate cancer.

Alternatively, if screening is not adopted, the experts say PSA testing should no longer be available on demand through GP surgeries, but only through a urologist, for men with urinary symptoms, which would rule out the concerned pit – with a possible exception for high-risk men.

Experts say PSA testing should no longer be available on demand through GP surgeries, but only through a urologist, for men with urinary symptoms, which would rule out the concerned pit – with a possible exception for men at high risk

Professor James Catto, a co-author of the article from the University of Sheffield, said: ‘Men who request PSA tests and are diagnosed with prostate cancer tend to be more affluent and involved in managing their health.

“We see an increase in demand from these types of men seeking PSA testing when celebrities like Bill Turnbull and Stephen Fry talk about prostate cancer, and that leads to overdiagnosis.

“But those who die from prostate cancer are the men least likely to request a test, so this system doesn’t work.”

“Also, although men in the UK are less likely to receive unnecessary treatment than in other countries, we want to minimize this risk by preventing men from being diagnosed with slow-growing cancers that they probably don’t need to know about after an unnecessary PSA test.”

Men aged 70 to 90 in the UK are twice as likely as men in their 50s to have a PSA test on demand.

This age group will make up a large proportion of the estimated 10,000 men in the UK who are ‘over-diagnosed’ with prostate cancer, who could have just lived with it without it posing a threat to their daily functioning or lives.

According to the article, up to half of men diagnosed with prostate cancer on a PSA test would never have noticed it otherwise.

But the diagnosis sets them on a medical path, starting with an uncomfortable biopsy and possibly leading to drugs that cause fatigue and loss of libido.

If their prostate is surgically removed or irradiated, they may develop bladder and bowel incontinence or erectile dysfunction.

If screening were implemented, only half of men, at the lowest risk of the disease, would need a PSA test just three times in their lifetime, evidence suggests.

The rest of the UK’s men would get tested between the ages of two and four.

As is currently happening in the UK, they would only be given a biopsy if an MRI scan given after the PSA test suggested they might have prostate cancer.

Commenting on the study, Chiara De Biase of Prostate Cancer UK said: ‘Clearly the current system requiring men to request a PSA blood test for prostate cancer is flawed – but without a national screening program it is best that we have. .

‘That’s why Prostate Cancer UK has developed a risk checker to help men make an informed choice about whether or not to get tested.’

Professor Nick James, from The Institute of Cancer Research in London, said: ‘I agree with the authors and strongly support the implementation of a risk-based approach to PSA testing at a national level.

“There is an urgent need for a more equitable and targeted screening strategy that could help address existing health inequalities.”