The Testing Choices campaign

The Testing Choices campaign aims to ensure that all men at higher risk of prostate cancer can access the balanced information and one-to-one support they need to make an informed choice about whether or not to have a PSA test.

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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:

  1. A prostate health community walk-in clinic
  2. A GP-based model
  3. 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

  1. Ream. E (2012). Evaluation of a Community-based Prostate Health Clinic in London. Commissioned by Prostate Cancer UK.
  2. 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.
  3. 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.