Welcome to the Real Prostate Cancer Risk Management Programme
This site has been set up by the Prostate Cancer Support Federation ("the Federation") as a resource for GPs to use, to help their male patients decide whether to have a Prostate Specific Antigen (PSA) test. All men at risk of developing prostate cancer (effectively men over 50, but this should be 45 where there is a family history of the disease, or other higher risk factors) are entitled to a PSA Test on the NHS every year.
The 'Real' Prostate Cancer Risk Management Programme updates the 'Official' Prostate Cancer Risk Management Guidance Pack, which was origianlly published by the Department of Health in 2002. That guidance advises GPs on how to advise a symptomless man who asks for a PSA test. Because this guidance is acknowledged to be out of date and is believed by many to be unbalanced, the Department initiated a revision programme in 2006.
In March 2009, when publication of the revised pack was imminent, the New England Journal of Medicinepublished interim results from two major studies into PSA-based screening for prostate cancer, one of which, the European Randomized Study of Screening for Prostate Cancer (ERSPC), showed significant reduction in mortality; the other, the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial in the US, showed no benefit. This completely opened up the arguments for and against screening, and rendered the revised guidance obsolete. The Department then announced that the National Screening Committee (NSC) was to be invited to reconsider the issue of a national screening programme for prostate cancer. The NSC is expected to report some time in 2010.
In July 2009, the Department published a slightly modified version of the revised guidance, which acknowledges the new research but still retains much of the sceptical tenor of the original guidance. Significantly, it fails to mention the fact that the issue has been referred to the NSC, implying instead that a decision against screening has been taken, when in fact it is under consideration.
Although the revised guidance is published with a letter from the Chief Medical Officer (CMO) that clearly states, in bold letters, that any man who is entitled to the test shall be given one if he asks for it, we are concerned that out-of-date information will continue to be given to patients who request a PSA test.
We believe it is important for GPs to be aware of the CMO's letter and the new evidence, of its implications for men who are deciding whether to have a PSA test to which they are entitled, and of the need for men to make up their own minds about it.
Accordingly we have produced a simple short leaflet in sufficient quantities for a copy to be held in every GP's surgery throughout the United Kingdom. The text of the leaflet has been produced by members of the Federation, but it has been reviewed and approved by eminent clinicians, and publication of the leaflet is supported and approved by Prostate UK, the UK's leading charity concerned with prostate diseases.
