Town centre ‘Man Van’ prostate cancer checks boost diagnosis – research

Taking a “Man Van” offering prostate cancer checks to shoppers and football fans could drive up detection of the disease, leading experts have found.
A study found that giving men access to cancer screening at places they go – such as shops and football clubs – encourages them to pop in for tests.
Men at high risk from prostate cancer, including black men and those from deprived areas, can also be more easily targeted with a mobile van, which is cheaper than GP visits, experts said.
It comes after Olympic cycling champion Sir Chris Hoy, who has terminal cancer, called for men with a family history of the disease and those at high risk to see their GP early on for a prostate-specific antigen (PSA) blood test.
The charity Prostate Cancer UK advises that black people – who have double the risk of the disease – or those with a family history of prostate cancer may want to speak to their GP about having a PSA test from the age of 45.
In the new study, experts wanted to tackle the fact that prostate cancer cases are picked up later – when they are less treatable – in areas of high deprivation and in ethnic minority communities.
They sent a “Man Van” mobile testing unit to target at-risk groups in London, working with local hospitals and community leaders to drive awareness.
The project successfully reached black men, who made up 16% of all van visitors, and picked up more problematic cancers – 86% – compared with other screening studies (50%).
Researchers estimated that using the vans could be up to 25% less expensive than men visiting their GPs for screening, with costs reducing from £68.41 via the GP to £51.11 through the van.
The Man Van project was developed by a group including the Institute of Cancer Research, London (ICR) and the Royal Marsden NHS Foundation Trust.
The nurse-led van was stationed in seven locations across London with ethnic minority communities and/or higher levels of deprivation, in sites such as a football club, a community centre, outside Ikea, a health centre and a town hall.
More than 3,000 men visited the Man Van over the course of a year.
Of the 94 prostate cancers detected via the PSA test, 81 (86%) were clinically significant – meaning treatment was likely to be needed to prevent the disease from progressing.
In other screening studies, 50% of cancers detected are clinically significant, meaning men are at risk of being sent for unnecessary treatment.
As well as the PSA test, men visiting the van had their blood pressure, body mass index and diabetes risk checked, with men told if they had diabetes or were at high risk.
The researchers suggest the Man Van model – combining education and awareness-raising with health checks – should be introduced into the NHS.
The NHS already runs mobile testing units for some other illnesses, including lung cancer checks.
Dr Masood Moghul, clinical research fellow at the Royal Marsden and the ICR, said: “This is the first evidence-based assessment of how mobile screening units could tackle health inequalities, reaching groups who have historically been diagnosed with cancer at a later stage when it’s more difficult to treat.
“The high number of black men that we reached, and the proportion of problematic but treatable prostate cancer that we detected – in areas where typically 25% of men present with incurable cancers – shows the success of this targeted outreach model.”
Professor Nick James, also from the Marsden and ICR, said: “Diagnosing cancer early is so important because it’s much easier to treat, but some cancers don’t have any symptoms until they’ve been growing for a while.
“It’s disproportionately people in deprived areas and from ethnic minorities who are having their cancers detected late, when it’s more likely to be deadly.
“To catch these cancers early, we need to be proactively helping people by offering health checks.
“As the debate continues for the best prostate cancer screening method – one that won’t cause over-treatment, or fail to detect people with deadly cancers – we need to improve healthcare access for those at a higher risk of disease.
“These results show that our Man Van is a very powerful model that should be considered for wider use across the country.”
Jonathan Gordon, 55, from Shepperton, Middlesex, had aggressive cancer diagnosed via the van. His treatment was a success.
He said: “My dad had prostate cancer when he was 60, but before I saw the Man Van on the news, I had no idea that that meant I was at high risk.
“I immediately booked myself a test in the van… I went to Chelsea Football Club to have my appointment.
“Had I not seen that announcement on the news about the Man Van, I doubt very much that I would have had a PSA test and I really don’t know where I’d be now. It definitely saved my life.”
The UK’s National Screening Committee does not currently recommend a population-based screening programme for prostate cancer using the PSA test, though it is conducting a review of the available evidence.
PSA level can also be raised because of conditions that are not cancer, such as urine infections or a benign enlarged prostate. The PSA test can also miss some prostate cancers.