Wales ‘lagging behind with cancer tests’
WALES is lagging behind other parts of the UK in offering a “breakthrough” diagnostic test for patients with prostate cancer, it is claimed.
A freedom of information (FOI) request from Prostate Cancer UK found just three out of seven Welsh health boards are providing a multi-parametric magnetic resonance imaging (mpMRI) scan before a biopsy. This is a special type of scan that creates more detailed pictures of your prostate than a standard MRI scan.
Out of those three, only Aneurin Bevan and Cwm Taf University Health Boards are providing mpMRI to a high enough standard to safely rule men out of biopsy.Prostate Cancer UK say this represents no improvement since health boards responded to an FOI on this in autumn 2016.
The level of provision compares poorly to England where the majority (92%) of areas are providing mpMRI before biopsy and 60% are providing to a high standard.
The FOI comes 18 months after the PROMIS trial first proved the mpMRI before a biopsy could radically boost detection of prostate cancer. Prostate Cancer UK is calling on the Welsh Government and health boards to take urgent action to end this variation in access.
Heather Blake, director of support and influencing at Prostate Cancer UK, said: “It is appalling that men in Wales should be denied the more accurate prostate cancer diagnosis that is becoming increasingly available to men in other parts of the UK. The evidence in support of mpMRI before biopsy is overwhelming - it is the biggest breakthrough in prostate cancer diagnosis for decades. This inequality in access cannot be allowed to continue.
“We want the Welsh Government and commissioners in Wales to take the lead from counterparts in other parts of the UK and prioritise making pre-biopsy mpMRI available to a high standard across Wales as a matter of urgency.”
In 2017, the Welsh Urology Board recommended for mpMRI before biopsy to be implemented to the PROMIS trial standard across Wales. A clinical consensus has now been developed by experts with support from Prostate Cancer UK and published in the July edition of the British Journal of Urology International.
Cabinet Secretary for Health Vaughan Gething said he expected health boards to incorporate pre-biopsy mpMRI into their diagnostic pathways for prostate cancer if Nice updates its guidelines to recommend it.
However, new Nice guidelines are not due until 2019 and will be based on already-published evidence. It is claimed waiting until 2019 will cause Wales to fall further behind the rest of the UK.
Mr Jim Wilson, chairman of the Welsh Urology Board, said: “The FOI data in Wales paints a disappointing picture.
“High-quality mpMRI before biopsy benefits patients through more accurate diagnosis and by safely ruling out unnecessary biopsies. Men in Wales should not be denied these benefits which are being made available to men in England.
“Waiting until April 2019 for the updated NICE guidelines will only cause Wales to fall further behind.”
A Welsh Government spokesman said: “Once we know the outcome of the review by Nice we would expect health boards to revise their diagnostic pathways accordingly. Health boards are already considering the potential impact of the revised guideline through the Wales Urology Board.”