Men across Wales “a step closer” to getting access to high quality diagnostic scans for prostate cancer

The National Institute for Health and Care Excellence (NICE) has published its final updated guidelines for prostate cancer diagnosis and management.

NICE now recommends that men with suspected prostate cancer should be offered an mpMRI scan before a biopsy.

The guideline also recommends that an mpMRI scan should be offered to men being monitored through active surveillance who have not had an MRI previously.

Now that the updated guidelines are formally published, Welsh Health Boards have the green light to put their plans into practice and make this breakthrough diagnostic technique available to men across Wales.

Andrew Seggie, Change Delivery Senior Officer at Prostate Cancer UK, said: “Now that the NICE guidelines have been finalised, men across Wales are a step closer to getting access to a consistent, high quality mpMRI scan before a biopsy.

We know that Welsh Health Boards have been working behind the scenes to overcome the challenges of adopting pre-biopsy mpMRI.

This breakthrough diagnostic technique should now be made available in all parts of Wales in the near future, ending the current variation in access that has resulted in some men paying privately for scans.

We want all men with suspected prostate cancer to have the chance of a more accurate, and often less invasive, diagnosis that an mpMRI scan before a biopsy can provide.

We’ll be doing everything we can to support Health Boards make this a reality.”

In January 2017, the PROMIS trial first proved that giving men with suspected prostate cancer a multiparametric MRI (mpMRI) before a biopsy could radically boost detection of prostate cancer.

It also showed that it can reduce the number of men having unnecessary and invasive biopsies by a quarter (27%) because the scan is more likely to pick up cancers which could cause men harm and need further tests.

Since then, Prostate Cancer UK has been working with the NHS in all parts of the UK and supporting the delivery of the service transformation needed to make these scans available to a consistently high standard.

According to a Freedom of Information Request conducted by Prostate Cancer UK in 2018, only three out of seven Welsh Health Boards are providing mpMRI before biopsy.

Out of those three, only two, Aneurin Bevan and Cwm Taf, are providing mpMRI to a high enough standard to safely rule men out of biopsy.

This represents no change since the Boards last responded to an FoI in Autumn 2016.

In March 2019 the Minister for Health and Social Services, Vaughan Gething, reiterated during a Welsh Assembly debate on the issue, that when NICE recommends pre-biopsy mpMRI, then he expects all health boards to amend their pathways accordingly.

North Wales AM Mark Isherwood welcomed the confirmation that NICE, he said:

“Having worked with mpMRI campaigners for a long time and made repeated calls for pre- and post-biopsy Multiparametric (mp) MRI scans to be made available to suspected prostate cancer patients in North Wales, I welcome this confirmation that NICE is now backing mpMRI scans as a cost effective first-line investigation.

In March 2018 NHS England announced that it was launching a one-stop service using MRI techniques to revolutionise prostate cancer treatment and slash the time taken for a diagnosis in England.”

Last December, NICE issued new draft guidance recommending pre-biopsy mpMRI for suspected Prostate Cancer.

In January, the Welsh Government Minister for Health and Social Services, Vaughan Gething AM, wrote to Assembly Members stating that he had asked all Health Boards to work with the Welsh Urology Board to ensure that they have full implementation plans.

Mr Isherwwod said: “In the same letter,  he stated that ‘Health Boards have confirmed that at present they deliver care in line with current NICE Guidance’.

Several North Wales patients subsequently reiterated to me that their care had not been delivered in line with current NICE Guidance.

As Prostate Cancer UK states, mpMRI revolutionises Prostate Cancer diagnosis.”

“The Welsh Government must now respond to their calls and those of others, including Tenovus Cancer Care, for the Welsh Government to ensure that mpMRI is available across Wales.

Although Vaughan Gething told the Assembly in March that when NICE recommends pre-biopsy mpMRI he will expect all Health Boards in Wales to amend their pathways accordingly, he must therefore now go further and ensure that they do.

We need to see significant rollout of mpMRI prostate cancer scans across Wales before 2020 and to hold the Welsh Government to account over its commitments”. Added Mark Isherwood.