We covered the issue of gender differences in healthcare provision in our 2015 election manifesto (pp. 61-5). More men than women die of cancer. More men die of prostate cancer than women die of breast cancer. At the time of our manifesto, £100m p.a. on the national screening programme for breast cancer, £150m p.a. was being spent on the national screening programme for cervical cancer.
There are, of course, no national screening programmes for male-specific cancers, and provision of resources for treating prostate cancer are poor. We pointed out in our manifesto that there’s a severe shortage of specialist NHS prostate cancer nurses, and prostate cancer patients endure long waiting times, a lack of access to drugs, pain medication, and trials.
Yesterday’s Times carried a piece on a proposed £175 genetic screening test for women. There are around 24 million women in the UK. If all took the proposed test, the cost would be around £4.2 BILLION. One of the cancers being screened for would be ovarian cancer, making it the third female-specific cancer with a national screening programme. The Times piece, by Kat Lay, Health Correspondent:
Offering every woman over 30 a test for cancer-causing gene mutations could prevent tens of thousands of ovarian and breast cancer cases, scientists say.
Public health chiefs said they would look “with interest” at a study showing that national genetic screening would save lives and be cost-effective.
Researchers calculated that if 71 per cent of women took up the £175 test, up to 17,000 ovarian cancers and 64,000 breast cancers could be prevented.
They also found that the move would be cost-effective according to criteria used by health chiefs to judge whether to fund new tests, drugs or treatments.
The research was carried out by a team from Barts Cancer Institute at Queen Mary University of London and Barts Health NHS Trust, supported by the London School of Hygiene & Tropical Medicine. It is published in the Journal of the National Cancer Institute.
At present women who develop cancer and their female relatives may be offered an assessment of their family history to determine their risk of having the rogue genes. If it is more than 10 per cent, they are offered genetic testing.
Ranjit Manchanda, consultant gynaecological oncologist at Barts, said that this process did not pick up every problem.
“Almost half of the people who are a risk will not give you the family history that fit the criteria. They will be missed. So why shouldn’t we offer it to everybody?” he said.
“Genomics is coming into healthcare in a big way . . . population testing is a way forward — we could maximise its potential for cancer prevention.”
Researchers calculated that screening all women over 30 would offer more benefit than the existing strategy and enough to be deemed cost-effective under National Institute for Health and Care Excellence rules.
Dr Manchanda said: “This could prevent thousands more breast and ovarian cancers than any current strategy, saving many lives.”
The genes that cause most inherited ovarian and breast cancers are mutations of BRCA1 and BRCA2. In 2013 the actress Angelina Jolie announced that she had had a double mastectomy based on family history and a positive BRCA test.
Women carrying either BRCA1 or BRCA2 gene mutations have a 17 to 44 per cent chance of developing ovarian cancer and a 69 to 72 per cent chance of developing breast cancer.
Women without the gene mutations have a 2 per cent risk of ovarian cancer and 12 per cent breast cancer risk. Each year in the UK about 7,400 ovarian and 55,000 breast cancers are diagnosed.
Anne Mackie, director of programmes for the UK national screening committee, said that it would “look at the results of this new research with interest”.
Experts cautioned, however, that further research into acceptability and feasibility would be needed before it could be rolled out.
Gareth Evans, professor of clinical genetics at Prevent Breast Cancer, said: “I would wholeheartedly support this research being taken to the next stage, provided that public health chiefs examine how women would consent to such tests.”
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