Contents
What is the PSA test?
The PSA test
is a blood test that can help diagnose prostate problems, including
prostate cancer.
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What is
Testing Choices trying to achieve?
Working out whether or not to have a PSA test is a 'testing
choice'. Men need to weigh up a whole range of pros and cons before
deciding if it's right for them.
To make an informed choice, men need to know about the test.
Yet, research by Prostate Cancer UK shows that two thirds of men
over 50 don't even know it exists.
Unfortunately, very little is being done by the NHS to improve
men's awareness. The current programme for helping men think about
the PSA test - the Prostate Cancer Risk Management Programme - only
helps men who already know about it.
We believe this has to change. We need a programme that's
able to reach every man who's at higher risk of prostate cancer,
not just the few men who are already aware.
We are delighted that, because of our campaign, the Government
has recognised that more needs to be done to help make men more
aware about prostate cancer and the pros and cons of being
tested.
Now, we need to find the best way to do this. PCUK has
identified a number of possible new ways of providing men with
information about the PSA test in partnership with men over 50,
health professionals and academics, which include:
- A prostate health community walk-in clinic
- A GP-based model
- A prostate awareness roadshow
These are currently being piloted, to identify the best practice
and inform development of a programme that better provides balanced
information about the PSA test. We will then campaign for this
programme to be put in place across the UK.
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Pilot 1: The Newham
Walk-in Clinic
The first pilot, a prostate health community walk-in clinic, was
delivered in Newham in partnership with Newham PCT and the North
East London Cancer Network. It ran between December 2010 and
December 2011. The clinic won an award
at the Quality in Care (QiC) Oncology Awards 2012 in the 'Helping
people live longer' category, and was second runner-up in the
'Patient experience' category.Whilst the service was valued, filled
a gap in current provision and attracted the right target audience,
key lessons were learnt that will inform development of future
pilots and services.1
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Pilot 2: The GP-based
model
The second pilot will run in Brighton and Hove in partnership
with Albion in the Community and local healthcare providers. It
will test how informed choice can be better delivered through
existing GP services by delivering targeted community awareness
activities and improving healthcare access for men at higher risk
of prostate cancer. Delivery is planned for August 2013.
The pilot will target men with risk factors for prostate cancer
(age, African Caribbean ethnicity, family history or existence of
Lower Urinary Tract symptoms) and will also aim to specifically
engage with men from lower socio-economic groups2 by
targeting areas with poor health deprivation and disability
rankings.3
For further information please email valentine.wonterghem@prostatecanceruk.org
(or contact the Specialist Nurses on 0800 074
8383).
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Further information
References
- Ream. E (2012). Evaluation of a Community-based Prostate Health
Clinic in London. Commissioned by Prostate Cancer UK.
- Research suggests that prostate cancer detection and outcomes
are worse in men from lower socio-economic groups, and that various
social factors might be responsible for poorer health behaviour in
these groups. Addressing inequalities in access to prostate cancer
information and care. Literature review, PCUK, 2012.
- Areas found to have poor Lower Layer Super Output Area (LSOA)
levels and Health deprivation and Disability rankings will be
targeted.
Why isn't there a national
screening programme for prostate cancer at the moment?
The UK National Screening Committee has decided that the
disadvantages of regularly screening every man over 50 for prostate
cancer using the PSA test outweigh the possible advantages. It has
been found that screening can reduce the number of deaths from
prostate cancer. But screening also leads to the over-diagnosis and
possible over treatment of 'harmless' prostate cancers that
wouldn't harm a man in his lifetime. At present, the Charity
supports this position on screening. But we are keeping a close eye
on developing research into screening for prostate
cancer.
What's the Government's
policy on PSA testing?
The UK Government also believes that all men are entitled to
make an informed choice about whether or not they should have a PSA
test, based on balanced information about its pros and cons. All
men are entitled to have the test on the NHS if they want it.
The Prostate Cancer Risk Management Programme (PCRMP) has been
developed for use by GPs. If a man wants a PSA test he can ask his
GP for one, and his doctor should give him balanced information.
The PCRMP has been adopted by the Health Departments in England,
Scotland, Wales and Northern Ireland.
If the Government supports
men's right to an informed choice about whether or not to have a
PSA test, why do we need this campaign?
The Charity believes that the PCRMP is not working. The
programme's messages are right but the way it is delivered is
wrong. It only helps men who are already aware of prostate cancer
and the PSA test. Men can only get information about the PSA test
if they already know to ask their GP for it.
Two thirds of men over 50 are unaware of the PSA test and one in
five GPs never talk about the PSA test with at-risk groups, unless
they have potential symptoms of prostate cancer. However not all
men with prostate cancer will have symptoms. This means that men
are not able to make an informed choice about the PSA test.
Prostate Cancer UK believes that the UK needs an improved
programme that better provides balanced information about the PSA
test and prostate cancer risk to all men aged over 50, and younger
men at higher risk of the disease.