Prostate cancer patients across the UK face a “postcode lottery” of care, a charity has warned, with men in Scotland almost three times more likely to be diagnosed at a late stage compared with men in London.
Prostate Cancer UK said the proportion diagnosed when the disease may be too advanced to treat varied hugely depending on where patients lived. Health leaders called the findings “shocking”.
In Scotland, more than a third (35%) of men are only diagnosed when the disease is classed as stage 4, meaning the cancer has spread to another part of the body – known as metastatic cancer. In London, the figure is 12.5%.
Prostate Cancer UK analysed various datasets to find out the proportion of patients diagnosed with metastatic prostate cancer – which in most cases is too advanced to cure.
There is a significant north-south divide. After Scotland, the next highest proportion of men diagnosed only at stage 4 was in north-east England and Yorkshire (20.1%), followed by Northern Ireland (20%), and Wales (19%). In the Midlands, 17.8% of men with prostate cancer are diagnosed late and 17.1% in the north-west.
The areas with the fewest men diagnosed at a late stage are all in the south or east of England. In the south-west, 16.8% of men are diagnosed at stage 4, 15.6% in the east, and 14.7% in the south-east, followed by London at 12.5%.
The analysis uses figures largely gathered before the pandemic, between 2014 and 2020. But the charity suggested outcomes for men were unlikely to have improved since then as health services across England, Northern Ireland, Wales and Scotland have all been under significant pressure.
One in eight men will get prostate cancer. Every year, almost 10,000 men across the UK are diagnosed with the disease at stage 4.
Laura Kerby, the chief executive of Prostate Cancer UK, said: “This postcode lottery for cancer diagnosis simply isn’t fair, and the picture in Scotland is particularly shocking. Every man should get an equal chance of a cure, which is only possible if his cancer is caught early.
“Unfortunately, early prostate cancer usually doesn’t have any symptoms, which is why men need to be aware of their risk and should take our online risk checker to find out more. If you’re at higher risk – which includes all men over 50 – you’re entitled to a free PSA blood test from your GP. Because of their higher risk, we strongly recommend that black men and men with a family history of prostate cancer should speak to their GP from the age of 45.”
Kerby raised concerns about fewer men being diagnosed since the arrival of Covid, saying there was “a long way to go to fully reverse the impact of the pandemic”.
The analysis also suggests men from deprived areas are at higher risk of being diagnosed at a later stage of the disease.
Chiara De Biase, director of support and influencing at Prostate Cancer UK, said the reasons for the huge geographical variation in late diagnoses were uncertain.
“We can’t say for sure what’s behind this gap in diagnosis, but it’s clear that men are more likely to be diagnosed at an earlier stage in areas with higher rates of PSA blood testing. That means the key way to tackle this is by raising awareness – especially in places like Scotland which are worst-affected.
“While we need to do more to raise awareness among men, we’d also strongly encourage GPs to take more of a proactive stance on PSA blood tests for men at highest risk.
“To this end, we’re supporting pilot schemes with GPs in areas of high deprivation to send targeted messages to encourage these men to come forward, and we’d like to see this rolled out more widely if successful.”
