The UK National Screening Committee has rejected calls for widespread prostate cancer screening, recommending testing only for a small group of men with specific genetic mutations. The decision, announced Friday, marks a significant setback for campaigners who have pushed for a national screening programme.
The committee concluded that population-wide screening using the PSA blood test "is likely to cause more harm than good." Instead, it recommended targeted screening every two years for men aged 45 to 61 with BRCA1 and BRCA2 gene mutations – affecting around three in every 1,000 men.
The draft recommendation explicitly rejected screening for Black men and those with a family history of prostate cancer, despite both groups facing significantly higher risk. The committee cited a "current lack of data and evidence" to justify screening these populations.
Why the committee said no
The PSA test's reliability remains the core issue. Around 75 percent of men with elevated PSA levels do not have cancer, while approximately 15 percent with normal results may still have the disease.
Professor Sir Mike Richards, the committee's chairman and former national cancer director, explained that "whole population screening may lead to a small reduction in prostate cancer deaths, but the very high levels of overdiagnosis" posed serious concerns. Research shows roughly 80 percent of prostate cancers identified through PSA screening would not benefit from early detection in terms of preventing deaths.
Treatment side effects compound the problem. Up to half of men who undergo prostate cancer treatment experience impotence, and a fifth suffer urine leakage – potentially unnecessary consequences for those with slow-growing tumours that would never have caused harm.
Charities express disappointment
Laura Kerby, chief executive of Prostate Cancer UK, acknowledged the frustration: «The committee's decision will come as a blow to the tens of thousands of men, loved ones and families who've fought for a screening programme.»
But she emphasized the significance of even limited progress: «While screening men with BRCA gene variations will save only a fraction of that, the committee's decision is the first time they've recommended screening of any kind for prostate cancer. It shows that research and evidence can shift the dial and save men's lives.»
Oliver Kemp, chief executive of Prostate Cancer Research, criticized the decision more sharply: «It is a missed opportunity for other high-risk groups, including black men and men with family history. We are failing these groups and entrenching inequalities further by not providing them with the best chance of having their disease caught early.»
Political pressure mounts
Health Secretary Wes Streeting faces considerable pressure to potentially overrule the committee's recommendation. More than 120 MPs, including former Prime Minister Rishi Sunak, have signed a letter calling a screening programme a "legacy-defining advance for men's health."
Former Conservative Prime Minister David Cameron also backed screening after revealing his own prostate cancer diagnosis Sunday. Olympic cyclist Sir Chris Hoy, diagnosed with terminal cancer originating in his prostate in 2023, has become a prominent voice calling for change.
Streeting stated: «I have always said I want to see screening in place for the most common cancer in men, provided this is backed by evidence. I want to change the NHS so it diagnoses earlier and treats faster. That aim will be balanced against the harms that wider screening could cause to men.»
He pledged to «examine the evidence and arguments in this draft recommendation thoroughly, bringing together those with differing views, ahead of the final recommendation in March.»
Research offers future hope
The £42 million Transform trial, launched by Prostate Cancer UK earlier this month, is exploring whether combining MRI or other scans with PSA testing could establish a viable nationwide screening programme. Results are expected within two years.
Kerby emphasized the trial's potential: «And the research programme that could achieve screening for all men is already under way – our £42 million Transform trial, which will bring new evidence back to the screening committee in just two years.»
The committee will collaborate closely with the trial to gather data on higher-risk groups. A 12-week public consultation on the draft recommendations begins now, with the final decision expected in March.
Prostate cancer affects more than 63,000 British men annually and claims 12,000 lives each year, making it the most common cancer in men. Currently, men over 50 can request PSA tests from their GP, but doctors are not permitted to proactively offer them.
Note: This article was created with Artificial Intelligence (AI).
