Key Points:
- NHS Prostate Cancer Screening pilots expand to detect cancer earlier in high-risk men.
- New blood tests and MRI-first approaches show promising accuracy in early detection.
- The program aims to reduce late diagnoses and improve survival outcomes across the UK.
An NHS screening program for prostate cancer could move forward today as the National Screening Committee evaluates new evidence on the benefits and risks of regular testing for older men. The committee, which advises the government on screening policy, is expected to issue its updated position after reviewing recent research on prostate-specific antigen (PSA) testing.
Committee weighs new evidence
The panel of doctors and economists will assess whether NHS prostate cancer screening men over 50 offers enough benefit to justify the potential harms and whether broad testing can be delivered at a reasonable cost to the NHS. The committee last reviewed the data in 2020 and rejected a national program, despite prostate cancer claiming 12,000 lives each year.
Pressure for change has increased in recent months, with public support adding urgency to NHS prostate cancer screening discussions. Olympian Sir Chris Hoy and journalist Dermot Murnaghan have publicly supported screening after being diagnosed with advanced disease. Former prime minister David Cameron also backed the campaign this week, revealing that he had recently undergone treatment.
Study shows reduced mortality
A key study under consideration found that regular PSA testing for men over 50 could reduce deaths by 13%. Researchers say the benefit is comparable to breast cancer screening. Lithuania is currently the only country to offer systematic PSA screening to men aged 50–69.
PSA is a protein released by prostate cells. Low levels are common, but elevated levels can indicate cancer. However, the test has limitations, which remain a central issue in NHS prostate cancer screening evaluations. One in seven men with prostate cancer show normal PSA readings, and high readings can result from slow-growing cancers that may never become dangerous.
Balancing risks and benefits
The committee has previously warned that widespread PSA screening could lead to unnecessary treatment, including surgery, radiation, or hormone therapy. Such interventions carry risks, including incontinence and impotence. Earlier concerns centered on the test’s ability to trigger overtreatment.
But diagnostic pathways have changed. Men with elevated PSA levels now typically receive an MRI scan, which reduces the chance of unnecessary procedures. Treatment methods have also improved, with fewer severe side effects reported in recent years.
Still, the committee may determine that the evidence is not conclusive enough to screen all men in their 50s and 60s as part of NHS prostate cancer screening. It may instead choose to wait for results from the Transform trial, a long-term study comparing different screening strategies. Findings from that trial could take years.
Focus on higher-risk groups
Campaigners hope the committee will at least recommend screening for men at higher risk of prostate cancer. Black men face twice the risk of those from other ethnic groups. Men with a father or brother who had prostate cancer have two and a half times the risk. There is also elevated risk for men whose mother or sisters have had breast or ovarian cancer. Roughly 1.3 million men fall into one of these categories.
Identifying these men could be challenging. Ethnicity is not always consistently recorded in GP files, and family histories are often incomplete unless a patient volunteers the information—an issue also relevant for NHS prostate cancer screening accessibility.
If screening is recommended, the proposal would likely go to public consultation before reaching Health Secretary Wes Streeting, who would make the final decision. His choice will determine whether targeted or wider screening becomes part of routine NHS care under the NHS prostate cancer screening program for the most common cancer in England.
