Understanding Prostate Cancer Screening: Essential Information

The UK's National Screening Committee has advised that only a select group of men at elevated risk should undergo prostate cancer screening. At present, the UK does not have a formal screening programme for prostate cancer, which remains the most common cancer among men.

There has been significant public discussion about changing this approach, driven by high-profile individuals such as Sir Chris Hoy, who is living with terminal prostate cancer, and Lord David Cameron, who recently shared that he had received treatment for the disease.

The committee's draft guidance will be open for consultation over the next three months. After this period, final recommendations will be delivered to the governments of England, Scotland, Wales, and Northern Ireland in March.

Understanding Screening

Screening involves testing people for a disease even if they show no symptoms. Examples in the UK include mammograms for breast cancer and the at-home bowel cancer test offered every two years to those over 50. The purpose is to detect cancer early, when it is more treatable.

Committee Recommendations

The panel concluded that broad screening for all men is not justified. Based on current evidence, screening is only recommended for men with confirmed genetic risks, specifically those carrying BRCA gene variants. For this group, testing every two years between ages 45 and 61 is suggested.

The committee did not recommend screening for other high-risk populations, including men with a family history of prostate cancer or black men, despite their higher average risk. This decision was based on uncertainties about the benefits and risks, as well as insufficient clinical trial data.

Rationale Behind the Decision

Mass prostate cancer screening could cause more harm than good. Existing tests are not always reliable, and men may receive treatment for slow-growing cancers that would not have caused harm. Treatments can result in serious side effects such as incontinence and impotence.

While early detection can save lives, distinguishing between aggressive and indolent cancers is challenging. The panel determined that the harms of overdiagnosis and overtreatment outweigh the potential benefits for most men.

Focus on BRCA Gene Variants

Men with BRCA gene mutations face faster-growing, more aggressive cancers at younger ages. Screening this group is considered beneficial, as early treatment can significantly improve outcomes. Genetic testing for BRCA1 and BRCA2 mutations is necessary to identify these men.

BRCA mutations increase the risk of multiple cancers, including prostate, breast, and ovarian cancers. About three in 1,000 men carry these variants, though many are unaware unless family testing has been conducted. Experts suggest expanding genetic testing for men at high risk to identify those who could benefit from screening.

Prostate Cancer Statistics

Prostate cancer affects roughly 55,000 men annually in the UK, with around 12,000 deaths each year.

Next Steps

Following the consultation period, the committee will finalize its advice to the UK nations. Each government will make its own decision on implementing prostate screening. England's Health Secretary Wes Streeting has emphasized that any screening programme must be supported by evidence and that he will carefully review the guidance before a final decision in March 2026.

Author: Maya Henderson