Prostate Cancer

The UK NSC policy on Prostate cancer screening/PSA testing in men over the age of 50

More Information

The prostate is a small gland in the pelvis that's found only in men. It's located between the penis and the bladder and surrounds the urethra, the tube that carries urine from the bladder to the penis. The main function of the prostate is to help in the production of semen. Prostate cancer is the most common cancer in men. It is responsible for 25% of newly diagnosed cases of cancer in England and Wales. The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 65 or older.

Image © Clinical Skills Ltd and provided courtesy of Cancerbackup.

» Read more about prostate cancer on NHS Choices

» Read more about prostate cancer on Cancerbackup

Policy Position

The UK NSC does not recommend screening men for prostate cancer. The reasons for this are given below.

PSA (prostate specific antigen) testing can, however, be performed on request. Information is provided on the risks and benefits by the Prostate Cancer Risk Management Programme.

This policy was reviewed in Dec 2010 but no significant changes were made. It is due to be considered again in 2013/14, or earlier if significant new evidence emerges.

Evidence Supporting the Policy

Two systematic reviews of prostate cancer screening were published in 1997 by the R&D Programme of the Department of Health. On the basis of these reviews, the UK NSC recommended to the Ministers of the four Health Departments of the United Kingdom that prostate cancer screening should not be introduced, and that men should not be invited for PSA testing in the way that women are invited for mammography. The main reason is that there was no good evidence of benefit from PSA testing when the evidence was set against the UK NSC criteria for screening programmes.

The UK NSC recognises, however, that many men ask for PSA testing either because they believe that PSA testing would increase the chance that their cancer would be cured if found, or simply to relieve their anxiety if the test result was negative. Therefore, a service to allow people to appraise the probable benefits and harms of the PSA test, called the Prostate Cancer Risk Management Programme, has been introduced. The key elements in this programme are:

• ensuring that people considering a PSA test are given all the information about the risks of the test, using methods for ensuring informed choice that have been tested in research settings and piloted in ordinary service settings
• ensuring that prostate specific antigen testing to an explicit quality standard is available to everyone who has a test
• ensuring the availability of a systematic and standardised follow-up pathway for people w hose test is above the threshold.

An updated Prostate Cancer Risk Management Programme Information Pack for Primary Care was sent out in September 2009. More information can also be found in the Cancer Backup booklet "Understanding the PSA test".

Stakeholders

The British Association for Cancer Research
British Association of Urological Nurses
The British Association of Urological Surgeons
Cancer Black Care
Cancer Research UK
Everyman
Macmillan
Orchid
The Prostate Cancer Charity
Prostate Cancer Support Federation
Prostate Scotland
Prostate UK
Royal College of Physicians
Royal College of Physicians of Edinburgh
Royal College of Surgeons
Tenovus

The stakeholder groups will be involved when the policy is next reviewed. If you think your organisation should be added, please contact us.

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