Prostate Cancer Screening: AI

Question

Asked by

To ask His Majesty’s Government what plans they have to use artificial intelligence in prostate cancer screening pathways to reduce late diagnosis of that disease.

My Lords, we are committed to looking for opportunities to implement AI in cancer services, investing £113 million in the AI in health and care award. As AI in screening is still in a trial phase, it will not be used in the targeted prostate cancer screening programme when this is introduced. However, we are maintaining the model used to develop this screening recommendation so that any emerging evidence that supports using AI in screening can indeed be considered rapidly.

My Lords, I thank the Minister for that Answer. A few months ago, I was diagnosed with prostate cancer. I want to thank the NHS for the excellent treatment it has been giving me, but it made it clear to me, after my first biopsy, that early detection was vital in the context of my treatment. I would also like to thank high-profile personalities, such as broadcaster Jeremy Clarkson, former soccer player John Barnes and, of course, Olympic cyclist Sir Chris Hoy, for making the same point about early diagnosis.

Prostate cancer is the most commonly diagnosed cancer in the UK and there is still no national screening programme. The UK National Screening Committee has admitted that its model does not look at artificial intelligence within the diagnostic pathway, but the model remains open to being updated. Can the Minister clarify how the evidence will be collected in relation to artificial intelligence? It is moving at pace in trying to sort out this terrible illness. How can the stakeholders engage with the committee?

I wish the noble Lord well as he deals with the diagnosis. I am sure that many would associate with his kind comments about the NHS care he has received.

I very much agree that early diagnosis is key. That is why we have introduced the first targeted prostate cancer screening programme. It will roll out next year and will focus on those at the highest risk. To the noble Lord’s question on AI, there is a whole range of ways in which we will gather the information necessary—for example, developing a new National Institute for Health and Care Excellence clinical knowledge summary. That will support discussions for those men who are not eligible for this programme. Also, through the cancer programme innovation open call, we will pilot the use of AI to assist radiologists using MRI to detect clinically significant prostate cancer. There is much scope in this area, and indeed our 10-year plan confirms that.

My Lords, while artificial intelligence may improve the interpretation of diagnostic tests and support earlier identification of prostate cancer, does the Minister agree that technology alone will not reduce late diagnosis unless it is embedded within a wider prevention and early detection strategy? What steps have been taken to ensure that AI tools are integrated into primary care pathways, with targeted outreach to high-risk groups, particularly Black men, and equitable access to different communities?

Yes, I agree with the noble Lord. While we are ambitious about the benefits of AI and wish to embrace them, we are equally clear that safety, fairness and public trust have to come first. That means that the National Commission into the Regulation of AI in Healthcare, which was established by the MHRA, will review the current regulations and provide the recommendations for a new regulatory framework. I assure your Lordships’ House that AI always will support professionals, not replace accountability.

My Lords, AI has the potential to significantly improve options for patients, but this will be possible only if NHS staff have the right skills, time and infrastructure to be able to test and use such tools. How will the Government invest in staff to help drive this innovation and improve outcomes for patients?

That is why we are publishing the workforce plan fairly soon, why we are building our cancer workforce and why we are creating new opportunities across multidisciplinary teams. Certainly, the use of AI is absolutely key, and we are, not least, working closely with the Royal College of Radiologists.

My Lords, at the other end of the scale of artificial intelligence is canine intelligence. The wonderful charity Medical Detection Dogs has had wonderful results in early and accurate diagnosis of prostate cancer. Are the Government looking at this as one of their diagnostic tools? If the Minister does not have labradors and spaniels in her brief, perhaps she can write to me.

I am so grateful to the noble Baroness, because I do not. However, I am aware of the great contribution being made to cancer detection, and the department is looking closely at that. I thank her for raising it.

My Lords, I warmly welcome the Government’s £42 million investment in the TRANSFORM trials, and I am extremely grateful. AI MRI tools are often trained on populations that underrepresent Black men, and they are at double the risk of prostate cancer. Will the Government require AI diagnostic tools to be independently validated on diverse populations before wider NHS use?

We always take into full account my noble friend’s very important point. She referred to the TRANSFORM trial, which will enable all eligible Black men to be invited to stage 2 of the trial. It is worth saying that Black men are historically underrepresented in clinical trials, and we are working closely with Prostate Cancer UK to work alongside and draw in communities from across the United Kingdom.

My Lords, I will follow up on that reference to the TRANSFORM trial. Black men are around twice as likely to develop prostate cancer and to die from it, yet historically they have been underrepresented in many screening and research programmes. The Minister mentioned the TRANSFORM trial, which hopefully will transform that inequality, but what assurance can she give that AI tools being developed for prostate cancer screening will reduce as much as possible any bias against higher-risk populations, such as Black men, and will not inadvertently widen health inequalities?

Yes, I can give that commitment.

My Lords, several trials are assessing the use of AI for prostate cancer screening and diagnostics, as well as testing the accuracy of digital imaging and histological imaging of biopsies to understand better the progression of disease. Some of them are well funded. For instance, the screening programme has £42 million of funding. Similar trials are conducted for lung, ovarian, breast and pancreatic cancer. The common issue that comes out is that we need digital transformation throughout the NHS to deliver any of these uses of AI for cancer. We need a workforce that is trained to use it, and I hope that the workforce strategy that the Government are about to publish will specifically include how the workforce will be trained to use AI in healthcare.

As I said, your Lordships’ House will not be waiting too long for the workforce plan, but I certainly recognise the noble Lord’s points. He describes the transformed service set out in the 10-year health plan, and the workforce plan will support that.

My Lords, although I very much welcome the programme for Black men, who are at greater risk, does the Minister not accept that very many of us who are not Black—I am one—have benefited from early diagnosis? Does she not accept that, going forward, it will not be sustainable to have testing available only to one ethnic group? It needs to be universal.