The UK's health service is set to maintain its current stance on prostate cancer screening, with a major review expected to reject calls for offering tests more widely to high-risk groups.
The Crucial Decision on Targeted Screening
After a comprehensive three-year review, the UK National Screening Committee will today advise ministers against routinely offering the Prostate Specific Antigen (PSA) test to two key groups known to face higher disease risk: Black men and men with a family history of prostate cancer.
This decision comes despite prostate cancer being Britain's most common cancer, affecting approximately 63,000 men and claiming 12,000 lives annually. Unlike established NHS screening programmes for breast, bowel and lung cancer, no national prostate screening exists.
Weighing Benefits Against Significant Harms
The committee's position stems from longstanding concerns about the PSA test's accuracy and the dangers of over-diagnosis. The test can identify slow-growing tumours that might never cause problems during a man's lifetime, potentially leading to unnecessary and life-changing treatments.
Such treatments can include prostate removal surgery, which carries risks of incontinence and erectile dysfunction, or gruelling chemotherapy that can shorten life expectancy, particularly in older patients.
However, the recommendation is expected to make an exception for men with the BRCA gene mutation, who will continue to be invited for PSA tests due to their significantly elevated risk.
Growing Pressure for Change
The committee's anticipated decision puts it at odds with prominent campaigners, including Olympic legend Sir Chris Hoy, who received a terminal prostate cancer diagnosis despite having a family history of the disease.
This week, former Prime Minister David Cameron revealed his own prostate cancer diagnosis, publicly joining calls for a targeted screening programme. More than 120 MPs, including ex-PM Rishi Sunak, have written to Health Secretary Wes Streeting urging him to introduce such measures.
Research suggests that mass population screening using PSA tests could reduce prostate cancer deaths by 13%, a figure comparable to the impact of existing breast and bowel cancer screening programmes.
Mr Streeting had previously vowed to launch a screening programme quickly if backed by the committee's review. There has been speculation he might overrule the committee, though charities strongly advise against this approach.
Chiara De Biase of Prostate Cancer UK told the Times: "We do not want a politically motivated screening programme. I'm a clinician first and foremost, we do no harm. We will absolutely stand by the outcome."
Similarly, Dr Ian Walker of Cancer Research UK warned it would set a "dangerous precedent" for the government to introduce screening regardless of the committee's decision.
Many experts argue that waiting for results from the major Transform trial, which is investigating the best prostate screening methods, represents the most evidence-based path forward for UK health policy.
