Prostate cancer is now the most common cancer among men in England. 1 in 8 will be diagnosed in their lifetime. For Black men and men with a family history of the disease that risk doubles to 1 in 4.
The positive news is that early-stage prostate cancer is very curable. 100% of men diagnosed with stage 1 prostate cancer will be alive after five years. However, when diagnosed at stage 4, that figure drops to 50%. The difficulty comes about because early-stage prostate cancer is commonly asymptomatic.
And yet, it is the only one of the four most common cancers not to have a screening programme.
The National Screening Committee (NSC) are currently evaluating the evidence for various screening proposals and are due to make a decision later this year. The road between what’s available now and the point of universal rollout of a national screening programme is long, but in the meantime the current NHS guidelines for diagnosing men are shockingly out of date.
Early-stage prostate cancer is most commonly asymptomatic, so it’s important for men to understand their risk of the disease. Despite this, the guidelines for health care professionals to diagnose prostate cancer – state that an asymptomatic man must proactively ask for a test from his GP. To do this he must somehow already know his risk and be confident in his navigation of the UK’s health services.
It is not hard to see how this arrangement is predisposed to help the men who are already more health literate and affluent, while leaving others behind.
The results of that are what we saw in the story which came out in January this year from the National Prostate Cancer Audit’s annual ‘State of the Nation Report’ for 2024. The findings from which are shocking.
From that report, it was confirmed that Black men have a 50% higher risk of being diagnosed with prostate cancer at stage 3 and 4, when compared to white men. This equates to a 1.5 times higher risk. Black men who get a later diagnosis are 14% less likely to receive life-saving treatments that have been approved by NICE for use on the NHS and are proven to be their best chance of a cure.
Prostate Cancer UK has warned that Black men are being put in disproportionate danger of dying from a curable disease, due to massive health inequities and outdated NHS guidelines.
This fresh data provides evidence for the first time that proves the depth of the inequalities Black men face when it comes to prostate cancer diagnosis and treatment.
Thankfully, there is a quick and simple political solution that could tackle these inequalities and give thousands more Black men the chance of a life-saving earlier diagnosis.
Prostate Cancer UK is calling on the Government to update NHS guidelines so that GPs can proactively start having conversations about prostate cancer with men at higher risk of prostate cancer, including Black men and men with a family history, from the age of 45, telling them about their higher risk and talking them through the option to have a quick, simple, and free blood test (the PSA blood test) that can check for signs of the disease.
Under current guidelines, it’s each man’s responsibility to find out his risk and ask for a test himself. Black men have double the risk of getting prostate cancer, but these guidelines treat them the same as other men with a lower risk.
This fails to address inequity in the healthcare system and is putting Black men’s lives at risk – an urgent situation as almost 1,600 Black men are diagnosed with prostate cancer each year.
This change to guidelines should not be viewed as a circumvention of the NSC or an ersatz screening programme, but rather a practical change which can be made tomorrow independently of that process. There are men in our society who cannot afford to wait any longer, and I believe this change should happen urgently
I’m joining Prostate Cancer UK in its call inviting the public to sign an open letter to the Wes Streeting asking the Government to change NHS prostate cancer guidelines here: https://prostatecanceruk.org/get-involved/campaigning/change-nhs-guidelines-now
It’s Time to the change the NHS guidelines for diagnosing prostate cancer
