Prostate cancer is the most common cancer among men in the UK. Leading data and analytics company GlobalData epidemiologists currently anticipate that there will be approximately 61,000 diagnosed incident cases of prostate cancer in men older than age 30 years in the UK in 2025. Despite this, there is currently no national prostate cancer screening programme in the UK, unlike there is for other common cancers (including breast, bowel, and cervical cancer). Instead, men are encouraged to request a blood test from their general practitioner (GP) at age 50 years (or from age 45 years in higher risk groups). Rapid at-home tests have also been released for public purchase. The at-home tests were intended to make prostate cancer testing more accessible, meaning that diagnoses would be made earlier and therefore improve disease outcomes. However, further research indicates that the at-home tests are unreliable and should not be used in place of a screening by a GP.
Prostate cancer occurs in the prostate gland, which is located just below the bladder in males and surrounds the top portion of the tube that drains urine from the bladder. This cancer typically spreads slowly, although it can be dangerous if it moves beyond the prostate. Patients with prostate cancer usually present with trouble or decreased force when urinating, blood in the urine or semen, bone pain, unexplained weight loss, and back, hip or, pelvis pain. When diagnosing prostate cancer, healthcare professionals typically use a laboratory test that measures the levels of the prostate-specific antigen (PSA) that is released by the prostate. High levels of PSA can be an indicator of prostate cancer and would encourage healthcare professionals to do further testing. However, in some cases, PSA levels may be high because of infection, vigorous exercise, or sex, and in other cases, PSA levels may be low despite the presence of cancer.
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The UK medicines regulator, the Medicines and Healthcare Products Regulatory Agency, says that over-the-counter PSA kits are “not a reliable indicator of prostate cancer” and must not “claim to detect cancer”. At present, Prostate Cancer UK, a prostate cancer research charity, has not tested the safety of the self-test kits. Although some tests have been quality assured, Prostate Cancer UK is hesitant to promote their use. Instead, the national charity suggests assessing potential risk factors and discussing the next steps with a GP. It is of paramount importance that people using the at-home tests are aware that they do not give the full picture, and a prostate cancer diagnosis cannot be deduced from the result. Men should be encouraged to get regular prostate screenings from GPs and ensure that they act proactively when noticing any of the symptoms associated with the disease. Sir Chris Hoy, a Great Britain Olympic gold medalist who was recently diagnosed with prostate cancer, has been calling for a lowering of the age at which those who are at higher risk such as Black men or those with a family history of prostate cancer, can ask their GP for PSA testing. The UK government says the current guidelines should not stop doctors from offering a test to those younger than age 50 years, but critics say the rules are unclear and there are huge variations in diagnosis rates between GP surgeries. GlobalData epidemiologists forecast that in 2025, out of the 61,000 diagnosed incident cases of prostate cancer in men older than age 30 years in the UK, 9,100 cases will be diagnosed with stage IV cancer. If the government acts proactively to encourage earlier screenings and discourage the use of unreliable at-home tests in place of screenings, fewer people will be diagnosed at a late stage and disease outcomes will be more successful.
