With headlines like these, it is no wonder that our patients feel let down by the NHS and fear that they may die of prostate cancer without it being diagnosed.

As well as trying to improve health and carry out our jobs, we must deal with the fallout of scaremongering and clickbait in our everyday clinics (i.e. MMR vaccination controversy)

So, I have written this to make our consultations easier and to make our patients feel safe.

We know that Prostate cancer is the most common cancer in men in the UK, with 1 in 8 men being diagnosed with prostate cancer in their lifetime.

One of the reasons there is currently no screening programme for prostate cancer in the UK is that the prostate-specific antigen (PSA) blood test, which is usually the first step towards a diagnosis, is not nearly accurate enough as a primary screening test.

The PSA test misses lots of prostate cancers that might benefit from treatment, and PSA levels can be raised when there is no prostate cancer present. The PSA test also detects diseases that would not cause problems in a man’s lifetime, leading to many cases of overtreatment and serious side effects.

Also, it may give us clinicians a false sense of security and that we can be more lax about finding out who are the men at most risk. We also know that many women don’t attend for cervical screening, so what if men are the same?

So, to ensure that we still “test” men who are most at risk, I have included a checklist of what we should ask and who we should test.

Don’t forget, if we consider that one of our patients should have a check, we have our autonomy, intuition and clinical judgement to justify testing anyone.

Going back to the cervical screening programme, we know, and new figures show more than five million are not up to date with their routine check-ups. (https://digital.nhs.uk/data-and-information/publications/statistical/cervical-screening-annual/england-2023-24)

So, will this be any different for men attending the screening? Also, with so many tests, it could take quite a while, especially initially, to process the results, with pressures on a service already under pressure.

So, we will continue as we have been doing for years, out of the spotlight, assessing and testing men whom we consider to be at risk in our own practice, an example below

  • Getting older – it mainly affects men aged 50 or over
  • having a family history of prostate cancer
  • being Black.
  • Men and Trans women who have a family history of breast or ovarian cancer linked to a mutation (change) in the BRCA2 gene are at an increased risk of prostate cancer.

*The risk factors for prostate cancer in trans women are similar. It is worth noting that when they have had gender alignment surgery, the prostate is not removed. Also, if they have been on hormone therapy, the prostate is slower growing, but there is still a risk.

https://prostatecanceruk.org/