John Lamont

I will make some progress, if I may, to develop a few arguments. I will take a couple of interventions, but I am conscious of the number of colleagues who are keen to speak. The petition argues: “Targeted screening for all high-risk men should be the starting point for building a screening programme that can ultimately protect all men.” It also questions the decision to offer screening exclusively to men with BRCA1 or BRCA2 genetic variants. Since the petition was launched, the UK National Screening Committee recommendation has narrowed, and the Government have now accepted screening for a a smaller group than the petition sought. The questions for us today are: who should be included? Why have other high-risk groups been excluded? And what evidence would justify widening the programme? Prostate cancer is the most commonly diagnosed cancer in men in the United Kingdom. More than 68,000 men are diagnosed annually, with over 12,000 dying from the disease each year. Patient survival hinges heavily on when it is diagnosed: if it is at stages 1 or 2, nearly 100% of men survive for five years or more, whereas if it is at stage 4, only about half live for five years or more. Sir Chris Hoy, Scotland’s most decorated Olympian, knows this better than anyone. He was diagnosed in 2023, in his 40s, after a scan for shoulder pain. He had no prostate cancer symptoms at all, yet by then the cancer had spread to his bones and was terminal. His father and grandfather both had prostate cancer. Under the programme that the Government have now accepted, a family history like his would not, on its own, qualify a man for screening. Last year, the broadcaster Dermot Murnaghan was diagnosed with stage 4 prostate cancer and, sadly, died in July this year. He said that he “fell through the gaps”, having assumed that the regular health checks he received would include a PSA—prostate-specific antigen—test. They did not. His message to other men was simple: “Get the test. Insist on the test.” Risk is not evenly distributed—age, family history, genetics and ethnicity all matter. One in eight men will develop prostate cancer during their lifetime, with the proportion rising to around one in four for black men. That is why the petition argues for screening to begin with men already known to be at greater risk.