Leading urologist advises that all men over 50 should request a PSA test from their doctor

 All men over 50 should visit their primary care provider for a PSA test, according to a renowned urologist in the UK.

Professor Hashim Ahmed, chair in urology at Imperial College London, said men should visit their GP for testing if they are over 50 years old, are members of a black ethnic minority, or have a family history of the disease last week on the Today show on Radio 4.

His remarks were in reaction to a Prostate Cancer UK survey that revealed men in Scotland are nearly three times more likely to have a late diagnosis than those in London.

The charity also discovered a North-South split, with north-east England and Yorkshire having the largest percentage of men with stage 4 or later diagnoses (20.1%), followed by northern Ireland (20%) and Wales (19%).

In an effort to increase awareness, Prostate Cancer UK is urging GPs to aggressively talk to higher-risk men about the PSA test.

The National Screening Committee's official position is that PSA testing for population screening is not advised as of the most recent update in November 2020.

According to the committee, while PSA-based screening is linked to an increase in prostate cancer diagnoses, the impact on death from prostate cancer specifically relative to no screening is still unknown.

And that screening could lead to consequences from biopsies and overdiagnosis.

The NSC came to the conclusion that it was unclear whether PSA-based screening programmes were beneficial or harmful overall. Research is ongoing to determine whether blood tests combined with risk ratings could be a more accurate method of identifying early disease, and another evaluation is due in 2023–2024.

In accordance with current government policy, PSA testing is accessible to any man over 50 who asks it and is given information about the dangers and benefits, but GPs shouldn't bring it up proactively with asymptomatic patients.

In order to spread awareness of early detection, Professor Ahmed added that at the time it is dependent on PR messages around high-profile cases like those of BBC presenter Bill Turnbill, who passed away from prostate cancer in August 2022.

And when they do visit their doctor, their doctors frequently dissuade patients from getting a PSA test because they are worried about the drawbacks of looking into prostate cancer.

He continued by saying that doctors were far better at identifying the illness, avoiding a biopsy with MRI scans, and developing better treatments.

Therefore, he said, "the message we need to get out to GPs is that we are lot better at diagnosing in a safer fashion, more accurate with least intrusive therapies that confer less harm."

Professor Ahmed responded to a question about what this meant for the general public by saying, "Over the last decade we've been pushing this mantra that if you have urinary symptoms go and get tested but actually often urinary symptoms don't reflect whether you have prostate cancer and if the urinary symptoms are due to prostate cancer it's almost too late."

So if you're 50 or older, go get tested. Start having tests done at age 45 if you are a member of the black ethnic minority or if you have a family history of the disease.

We are largely dependent on males being proactive until we have a nationwide screening programme where the government sends out a letter and requests that people have a PSA blood test, and it's going to take some time to get that sort of national breast cancer type screening programme underway.

Comments regarding universal PSA testing should not have gone unchecked in the interview, according to Dr. Margaret McCartney, a general practitioner in Glasgow and the creator of the RCGP overdiagnosis subgroup.

Which patients, in their opinion, should wait longer so that we can complete this work? is the question I'd like them to respond to. Why are they indicating a desire to defy official recommendations? Why do they use their own PSA screening recommendations rather than sending males to the NHS? What studies have they conducted on the application of their advice?

I'm quite upset that the media has not questioned these claims.

When contacted for response, a DHSC representative stated that the screening committee would be reviewing prostate screening as part of routine business in 2023–2024.

A countrywide lung cancer screening programme is now being developed after the screening committee originally suggested a rollout last year.