One in four men identified with abnormal PSA test results may have prostate cancer but are not being referred for further investigation, according to retired urologist and men’s health campaigner Professor Chris Booth.
Prof Booth, Founder and Chairman of men’s health charity CHAPS, warned the UK’s lack of a national prostate cancer screening programme is creating a “postcode lottery” in diagnosis and leaving potentially hundreds of men without access to timely treatment.
His warning comes on the back of new figures showing that fewer than five per cent of men diagnosed with prostate cancer receive their results within the NHS target of 28 days.
Prof Booth said inconsistent guidance surrounding PSA [Prostate-Specific Antigen] testing means many GPs are either reluctant or refusing to offer tests altogether.
“A lot of GPs are now refusing to do PSA tests at all,” he said.
“I know of eight practices around Ipswich alone which refuse to offer them.
“That means men are increasingly relying on charities like CHAPS for access to screening through workplace programmes and community events.”
CHAPS has now carried out PSA testing for around 12,000 men across the UK. According to the charity’s data, approximately eight per cent receive abnormal results requiring further investigation.
However, Prof Booth said only around half of those men are subsequently referred to specialists by their GP.
“Of the men we identify with abnormal PSA levels and advise to see their GP, around half are not referred for further investigation,” he explained.
“Among the men who are referred, around half are found to have cancer.
“When you account for cases where GPs identify non-cancerous causes such as benign prostate obstruction, my professional estimate is that around one in four of those men who are not referred will still have cancer.
“That means potentially 125 men we have identified with abnormal PSA results may have prostate cancer but are not reaching specialist care.
“That is an unacceptable situation.”
Prof Booth said the current approach to prostate cancer diagnosis lags significantly behind other major cancers because there is no national screening system in place.
“We don’t tell women to come back when they find a lump,” he said.
“Quite rightly, we have national screening programmes designed to identify cancers earlier, when treatment is more effective and survival rates are higher.
“Prostate cancer is now the most common cancer in the UK and yet it remains the only major cancer without a national screening programme.”
He said introducing a nationwide programme could dramatically improve outcomes while also reducing pressure on overstretched GP services.
“I believe we already have the framework needed to establish a national prostate cancer screening programme within three years,” he said.
“Pilot schemes have already demonstrated multiple successful screening models which are identifying clinically significant cancers requiring treatment.
“A centrally managed programme led by specialist teams would be more practical, more consistent and more cost-effective than relying on already overstretched GP practices to manage this individually.”
Prof Booth also warned the current system is creating unnecessary pressure elsewhere in the NHS.
An audit carried out by CHAPS at one hospital found that 25 per cent of referrals to secondary care were unnecessary, highlighting the need for a more streamlined and specialist-led pathway.
“The entire system for men’s health and prostate cancer referrals needs reorganising,” he said.
“If we are serious about improving survival rates and early diagnosis, we need to stop delaying and get on with delivering a national screening programme.”