Prostate Cancer (Hansard, 3 May 2000)

HL Deb 03 May 2000 vol 612 cc1018-20 1018

§ 3.12 p.m.

§ Baroness Gardner of Parkes asked Her Majesty's Government:

§ Whether, at a time when the number of late diagnosed and often untreatable cases of prostate cancer in the United Kingdom is rising, they will introduce routine screening for men over 50 by PSA blood test.

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, the UK National Screening Committee does not currently recommend prostate cancer screening based on the prostate specific antigen (PSA) test as with existing technology for treatments and testing there is no evidence that a screening programme would save lives, and evidence that it could cause large numbers of cases of impotence and incontinence. However, we believe that that this issue is of such importance that we have asked the committee to keep it under review and consider any new evidence.

§ Baroness Gardner of Parkes
My Lords, I thank the Minister for his reply which is contrary to the press reports this week as regards Mayor Giuliani. Does the Minister agree that there is a major difference between the level of screening of women for breast cancer and men for prostate cancer? Is that sex discrimination, a lack of men's awareness of the availability of tests, or simply the traditional unwillingness of macho man to address health issues?

§ Lord Hunt of Kings Heath
My Lords, colorectal screening for men is being piloted at present. We shall keep under review the issue of screening for prostate 1019 cancer. As the national committee advised Ministers in 1997, there are real problems in this area. There is no consensus of medical opinion on how to treat the disease. The test has a limited accuracy and could lead to a positive test for those without the disease.

§ Lord Clement-Jones
My Lords, the Minister described how the Government intend to proceed. The National Screening Committee has advised against universal application of the PSA test. However, Britain has one of the worst records for prostate cancer in terms of outcome. Its record is worse even than that of Estonia and Poland. Does the noble Lord have a prescription for future improvement of prostate cancer services?

§ Lord Hunt of Kings Heath
My Lords, it is good to hear the name of Estonia back in your Lordships' House. I assure the noble Lord that the Government are far from complacent about the impact of prostate cancer. It is important that the decision on action to be taken is made on the best available evidence. The evidence from the committee advising Ministers is that it would not be appropriate to extend testing in the way suggested. We are anxious to do all we can. We have announced that an action plan will be developed over the next few months which will take in research, diagnosis and care. We are anxious that as much information as possible is available to men so that they are able to make informed choices.

Baroness Sharpies
My Lords, will the Minister say where the pilot scheme is taking place and how many patients are involved?

§ Lord Hunt of Kings Heath
My Lords, I assume the question relates to colorectal cancer. I do not have the information to hand but I am happy to write to the noble Baroness.

§ The Countess of Mar
My Lords, how many research projects are in hand at present which are considering not only treatment but also causation? Has the Medical Research Council plans to fund any more?

§ Lord Hunt of Kings Heath
My Lords, since 1997 the Government have directly committed more than £800,000 to new prostate cancer research projects. In addition, the department provides support to the NHS for research commissioned by the medical charities and the Medical Research Council. Over £60 million of that funding supports cancer research overall, with £16 million going to the Royal Marsden Hospital. The Royal Marsden Hospital estimates that nearly £1 million of that Department of Health support funding relates to work on prostate cancer.

§ Earl Howe
My Lords, I acknowledge that there is still uncertainty about the most effective treatment for men with early stage prostate cancer, but what role do the Government envisage for the technique known as 1020 radioactive seed implantation for the treatment of prostate cancer? Are there any plans to make it more widely available in the UK than at present?

§ Lord Hunt of Kings Heath
My Lords, the National Screening Committee will keep the matter under constant review. As and when they arise, potential new tests will be considered on their merits. The National Screening Committee is charged with discussing again the whole issue of screening at its next meeting. Alongside that, the development of an action plan by the department in the summer will enable us to keep pace with developments in the UK and other countries and ensure that we keep up to date with the best available evidence. I assure the noble Earl that we shall take into account any new developments which come onstream in other countries.

§ Baroness Gardner of Parkes
My Lords, has the Minister seen the report in the medical column of The Times this week? It stated that there is proven evidence of a great decline in deaths from prostate cancer in the United States whereas in this country the figure is described as soaring.

§ Lord Hunt of Kings Heath
My Lords, I have not seen the article. However, as I said, we shall ensure that any new research which becomes available is fully considered. My figures suggest that the incident rates of prostate cancer in this country are expected to level off in future years. At the same time, it is essential that we develop screening programmes only when we have advice that it is effective to do so. That will remain the Government's policy.