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Early diagnosis is an important part of effective treatment for prostate cancer. From next year, and over the following five years, we will roll out diagnostic tests
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that can confirm or exclude cancer within a week. We believe that faster access to diagnostic tests, alongside work on early detection, will help save up to 10,000 lives a year. Screening is therefore an important tool in early diagnosis, and that is why we have developed world-class screening programmes for breast, bowel and cervical cancers. Although there is currently no automatic national screening programme for prostate cancer, we remain committed to introducing new screening programmes as and when they are proven to be both clinically and cost effective.

Research published last March in the New England Journal of Medicine has shown for the first time that screening for prostate cancer can reduce the death rate by 20 per cent. However, it also showed that more than 1,410 men needed to be screened to save one life-and that 48 of those would end up being treated unnecessarily, with all the side effects that that can cause. There are therefore problems to do with screening that we really need to resolve before any test is introduced on a national basis, because treating 48 people unnecessarily to save one life would pose significant difficulties. We have asked the UK National Screening Committee to review this evidence and to make a recommendation on prostate cancer screening by the autumn of this year.

As part of our prostate cancer programme, we have established the prostate cancer risk management programme, to which the hon. Gentleman referred. This ensures that men considering a prostate-specific antigen test are given the information that they need about it. For a while a PSA test can help with diagnosis, but it is not perfect. Some men with prostate cancer do not have raised PSA levels, and, depending on the cut-off level used, two thirds of men with raised PSA levels do not have prostate cancer, so the test is not perfect. It can lead to false-positive and false-negative results, and that is why PSA tests divide opinion among GPs and, indeed, other clinicians. Some are concerned about them because of those issues, and the PSA test cannot distinguish between men with slow-growing prostate cancer, which may have no effect on a man's natural lifespan, and those who have a more aggressive disease.

The hon. Gentleman asked about choice. In 2010 all GPs in England were sent a pack of materials to give their patients the information that they need to make an informed choice about the PSA test. Our policy, as he rightly says, is that if a patient wants a test, after considering the benefits, limitations and risks associated with it, they should receive one on the NHS. Based on an evaluation of the ongoing prostate cancer risk management programme, a revised information pack was sent to GPs in July 2009, six months ago. In August the chief medical officer then wrote to all GPs to remind them that their patients should be given access to PSA tests in accordance with the PCRMP.

A lot of information is thrown at GPs, so we need constantly to remind them to do various things, because we ask them to do so many. The hon. Gentleman is right that, sometimes, feedback from polls states that some GPs do not know about the test. It does not mean that they have not been told; it may mean that they have been told but, given the sheer volume of information that they are sent, have forgotten it or do not have it at the forefront of their mind.

It was recognised that some GPs are unaware either of the original pack or of their patients' right to a PSA test, so an action plan to engage GPs better has been
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developed. There has already been a trade media launch and a webcast, and GPs now have the PCRMP materials on their IT systems, helping them better to support their patients. Other plans to remind them include a roadshow for GPs and a peer-reviewed paper in the British Medical Journal. The campaign to alert men to prostate cancer is therefore enormously important, and I welcome the stories that have appeared in the Daily Mail. That work is valuable in alerting men and getting them to go to their GP if they have problems, and reminding GPs that men should be given the PSA test. Such campaigns can save the lives of many men, so I welcome the work of the Daily Mail. Whether the drug that we have discussed is a "wonder pill" is another matter, but we will see what the outcome is of the clinical trials.

Once diagnosed, patients are entitled to receive the best possible care on the NHS. The National Institute for Health and Clinical Excellence has published a series of improving outcomes guidance covering all major cancer tumours, including urological cancers such as prostate cancer. It recommended the way in which primary care trusts and cancer networks should organise cancer services to ensure the best outcomes, and the national cancer action team monitors progress against those plans. In 2008, NICE also published new guidelines on the diagnosis and treatment of prostate cancer, and they recommended good practice based on the best available evidence and professional opinion.


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However good our treatment today, we must always strive for more, as the hon. Gentleman rightly said. We can still continue to do better. The Government are among the largest funders of cancer research, along with the industry and the cancer research charities. Through the Medical Research Council and the National Institute for Health Research, we fund about £250 million of cancer research every year. The vast majority of this money supports clinical trials and research undertaken by our partners in the public and charitable sectors. We are very proud of our record of excellence in health research and of what its results mean for people not only in the UK but around the whole world. Britain is one of the leaders in cancer research. The Government are determined to continue to do whatever we can in the fight against cancer: it is an enormously high priority for us. Our excellent record of high investment and high ambition is saving more lives today. We have a long way to go in the fight against cancer, but we must, and will, strive to do more.

Finally, I wish Mr. Walker well in his continuing treatment and hope that it brings with it some success.

Question put and agreed to.

6.30 pm

House adjourned.


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