ONE in three men in Scotland with prostate cancer are diagnosed too late for a cure.
Charity Prostate Cancer UK has described the situation as "shocking" as national figures revealed what they describe as "a north-south divide" whereby men in Scotland are more than twice as likely to be diagnosed once the disease has already spread compared to men in London and the South-East.
The charity also warned that referrals were not rising fast enough to catch up with a backlog of missed cases during the pandemic, with almost 60 per cent of patients also waiting more than two months to start hospital treatment after an initial referral for tests - the longest delay for any cancer type in Scotland.
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Laura Kerby, chief executive at 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."
New data from the UK-wide National Prostate Cancer Audit (NPCA) shows that 35% of men diagnosed with prostate cancer in Scotland between 2014 and 2018 were detected at stage four - equivalent to 1,059 men a year on average.
In Northern Ireland, Wales, and the North East of England & Yorkshire region, around 20% of men were diagnosed at stage four. In the Midlands and North-West England this fell to around 17-18%.
However, in London, just one in eight prostate cancer cases (12.5%) were stage four, with just under 15% detected at stage four in the South-East of England.
Early prostate cancer tends to be asymptomatic.
However, Prostate Cancer UK is encouraging men to use its 30-second online risk checker as men who are at higher risk of the disease are entitled to a free blood test by their GP to measure their PSA levels - a protein biomarker which can signal the disease.
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Men over 50 are more susceptible, but the charity strongly recommends that Black men and men with a family history of prostate cancer - who are at highest risk - should speak to their GP from the age of 45.
Jaimin Bhatt, a consultant urological surgeon in Glasgow, said: “In its early stages, prostate cancer is a very treatable disease, but once it has spread to the bones, it’s impossible to cure.
"Working in urology I’ve seen first-hand the difference this makes for men, which is why it’s awful to hear so many men in Scotland are being diagnosed at this late stage."
In June 2021, Gareth Jones, a 55-year-old surgeon from Cambuslang, was shocked to be diagnosed with advanced prostate cancer.
He said: "I was really fit and healthy, but I kept getting these niggling injuries, like pains in my back that were starting to really affect me.
"Little did I know this was a sign my cancer had already spread to my bones. Being diagnosed was very, very difficult, but thankfully I started my treatment that same day so there were no delays.
"I’m determined to live life to the full and I’m now back in the gym and am doing what I can to raise awareness.
“I just don’t want this to happen to other men, and it can be avoided if more men know about prostate cancer and what to do about it.
"That’s why I would tell anyone and everyone to share Prostate Cancer UK’s risk checker because we need to get the message out there and stop so many men in Scotland missing out on an early diagnosis.”
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The Scottish data also shows a dramatic 18% fall in the total number of men who first started treatment for prostate cancer in Scotland during the first year of the pandemic, which could result in higher risk of metastatic diagnoses for years to come.
Meanwhile, new analysis by Prostate Cancer UK also shows significant variation in how quickly different regions are recovering from the pandemic.
While referrals in England are now above pre-pandemic levels, it warned that referrals in Scotland and Wales have not yet risen to the levels needed to deal with the backlog in diagnoses.
At the same time, more than half (57%) the men who need urgent prostate cancer treatment in Scotland are waiting longer than two months for hospital care, according to the most recent figures for July to September last year.
There is also a postcode lottery by health board.
In Ayrshire and Arran, 93% of men started treatment within 62 days of an "urgent referral with suspicion of cancer", compared to just 20% in NHS Greater Glasgow and Clyde.
The findings come almost a year after it was reported that, UK-wide, 14,000 fewer men then expected had been diagnosed with prostate cancer between April 2020 and December 2021.
Ms Kerby said there was a "long way to go to reverse the impact of the pandemic", adding: “At one point in the pandemic, prostate cancer made up a third of all missing cancer cases, so while we’re pleased to see that referral levels recovering, it’s concerning that men are now waiting longer for treatment as a result."
The Scottish Government is currently developing its updated cancer strategy and action plan for Scotland, which will include a focus on earlier diagnosis.
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