A report released by the Royal College of Surgeons shows more men are getting an appropriate level of treatment, but issues with late diagnosis persist and uptake of mpMRI has been patchy. However, a pilot scheme also announced today offers a promising step forward.
The National Prostate Cancer Audit is essentially a state of the nation report on prostate cancer care in England and Wales and presents data from the point men are diagnosed, through to the outcome of their treatment.
The latest report, released today, shows that men diagnosed in 2015/16 were more likely to be getting an appropriate level of treatment compared to men diagnosed in 2014/15. Fewer men with advanced prostate cancer were under treated and fewer men with low-risk disease were treated unnecessarily. The latter is probably due to more men being offered active surveillance.
Worryingly however, the audit also shows there are still large numbers of men being diagnosed at an advanced stage of the disease, when their chances of survival are reduced. Also, uptake of multi-parametric MRI (mpMRI) before biopsy, which can improve the accuracy of diagnosis, is patchy across England and Wales.
In Wales the findings suggest that Welsh Health Boards are lagging behind the NHS in England when it comes to ensuring this ground-breaking technique becomes a routine part of the diagnostic pathway. However, we know that since the audit data was collected, key areas such as Newport and Cwm Taf have made great strides towards the implementation of this crucial diagnostic. Progress is now needed across the whole of Wales so all Welsh men can benefit from a more accurate diagnosis.
Heather Blake, Director of Support and Influencing at Prostate Cancer UK said: “Finding a way to routinely achieve early and accurate diagnosis is crucial if we are to save more lives from prostate cancer. We are investing heavily in research to develop a tool which, in the future, could be used as part of a national screening programme to increase early detection.
“In the meantime, giving men with a raised PSA a multi-parametric MRI (mpMRI) scan before a biopsy will play a key role in improving the accuracy of the current diagnostic process. As the audit shows, much more still needs to be done to ensure this ground-breaking technique becomes a routine part of the diagnostic pathway in every area of the UK".
In a separate announcement today, NHS England has confirmed a promising step forward when it comes to ensuring this diagnostic technique is adopted more rapidly and consistently. It will be funding a pilot project at three NHS Trusts to test a new model of care that uses mpMRI scans to reduce average prostate cancer diagnosis time to just eight days and referral-to-treatment time to 20 days. Funded by the National Cancer Transformation Programme the new process sees patients receiving an mpMRI scan and report, a clinical review and, if necessary, a targeted biopsy all on the same day.
Heather added: “The results of the PROMIS trial showed how mpMRI can improve the accuracy of diagnosis. This pilot will help to show how NHS resources can best be used so that adoption of mpMRI drives a reduction in time to treatment.”