With late-stage diagnosis of prostate cancer still on the rise, Rebecca Porta, Orchid’s Chief Executive, explains why, and depicts the importance of risk awareness.

The Problem: Late-Stage Diagnosis

Prostate cancer is now the most commonly-diagnosed cancer in men in the UK, with nearly 50,000 cases in 2018. While it was encouraging to hear from Public Health England that the increase in prostate cancer diagnoses is a result of more men getting tested, the fact remains that incidence is rising and around 12,000 men are dying from prostate cancer in the UK each year. (1) Furthermore, around four-in-10 prostate cancer cases are diagnosed at a late stage (stage III or IV) in England and Northern Ireland, and as many as six-in-10 cases are diagnosed at a late stage in Scotland. (2)

Problematically, late-stage diagnosis of prostate cancer is at an all-time high and shows no sign of letting up across the UK. Statistics from the National Cancer Registration and Analysis show a year-on-year increase of 11.27 per cent between 2012-to-2017, with the latest figures showing that 42.5 per cent of prostate cancer diagnoses are now made in the late stages. (3) The impact of late diagnosis can significantly reduce chances of survival, limit treatment options, or result in more invasive interventions for patients.

Explaining the Problem: Poor Awareness of Risks and Symptoms

For the general population, one-in-eight men are at risk of prostate cancer, but for Black African and Black Caribbean men, it is one-in-four. Problematically, awareness of prostate cancer risk among men has been shown to be poor. In a survey commissioned by Orchid, nearly a third of men (31.4 per cent) said that they knew nothing about prostate cancer, and over three-in-five men said that they were not confident in identifying the signs and symptoms of the condition. (4) Furthermore, nearly three-in-four men were not aware that prostate cancer most commonly affects men over 50 and that their ethnicity can impact their risk of developing prostate cancer.

Low prostate cancer awareness is not limited to the public either. Orchid commissioned another survey which demonstrated that even among GPs, more awareness of risk factors and the symptoms of prostate cancer is needed. (5) Only five per cent identified ethnicity as one of the primary risk factors for prostate cancer, even though Black African and Black Caribbean men are twice as likely to be diagnosed with the disease than other men. In addition, less than half of GPs identified the remaining two key risk factors of age (44 per cent) and family history (47 per cent). These statistics were made more concerning by the fact that 84 per cent of survey participants felt that training for GPs on prostate cancer risk factors and symptom awareness was sufficient.

Solving the Problem: Awareness Campaigns

To combat the issue of late-stage diagnosis, more men need to visit their GP earlier, and it is vital that both men and GPs are aware of their or their patients’ risk to facilitate this. Men at-risk must be empowered to visit their GP and be checked as early as possible, rather than wait for symptoms to develop, which can result in late-stage diagnosis. Similarly, while we appreciate that GP time is limited, we urge them to incorporate a prostate cancer awareness discussion into every consultation with at-risk men to aid earlier diagnosis of prostate cancer further.

To help tackle the problem, Orchid launched and drove a specific campaign to improve prostate cancer risk and symptom awareness among men, called #FaceuptoProstateCancer.    

The campaign was based on ‘FACE’, an easy to remember and understandable acronym for three key risk factors of prostate cancer and one major symptom: Family history, Age, Change in urinary habits and Ethnicity. This has proven to be highly successful, with widespread coverage across national press and social media.

Encouragingly, the GP survey conducted by Orchid demonstrated that GPs largely agreed with this approach. The vast majority (85 per cent) said that they believed that the most effective way to increase earlier diagnoses of prostate cancer is to undertake public health awareness campaigns specifically targeting men from high-risk groups, and encouraging them to speak to their GP about their risk. (5)

What Next?

The reality is that until a reliable and comprehensive tool for diagnosing prostate cancer is established, the key to earlier diagnoses is for men to be more aware of their risk and to have informed conversations with their GP if they find themselves at risk or have any concerns. It is therefore imperative that we continue to drive awareness of prostate cancer and ensure that as many men as possible are being diagnosed in the early stages.

Looking ahead, Orchid will continue to drive the #FaceuptoProstateCancer campaign, seeking to entrench the FACE acronym and risk awareness to help both healthcare professionals and men to beat prostate cancer through earlier diagnoses.

Orchid – Fighting Male Cancer is the UK’s leading charity covering the three male-specific cancers. The charity exists to save men’s lives from testicular, prostate and penile cancers through pioneering research, education programmes, promoting awareness and a range of support services.

References

1. Cancer Research UK, www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer#heading-One, (Accessed: 19 March 2020)

2. Cancer Research UK, www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer/incidence#heading-Three, (Accessed 26 March 2020)

3. National Cancer Registration and Analysis Service (2019) Stage breakdown by CCG 2017: TNM stage group by CCG by tumour type for 10+3 tumour types, 2012-2017 Available at: www.ncin.org.uk/publications/survival_by_stage (Accessed: 19 March 2020)

4. Orchid – Fighting Male Cancer. (March 2018). The Orchid survey of Men’s Attitude to Prostate Cancer Risk. Censuswide. The survey was conducted from a sample of 1,101 UK males

5. Orchid – Fighting Male Cancer. (August 2019). Prostate Cancer: Survey of GPs. Censuswide. The survey was conducted from a sample of 100 UK GPs