The UK National Screening Committee (UKNSC) has recommended against routine prostate cancer screening for the majority of men, citing that the harms would outweigh the benefits. The draft advice, which has drawn criticism from charities, suggests that a targeted screening programme should only be offered to men with confirmed BRCA1 or BRCA2 gene mutations, who are at higher risk of aggressive cancers.
The committee's modelling indicates that universal screening would lead to a small reduction in prostate cancer deaths but at the cost of very high levels of overdiagnosis. An estimated 40-50% of cases detected via PSA testing would be slow-growing and unlikely to cause harm, yet treatment could result in lifelong side effects such as incontinence and erectile dysfunction.
For black men, who have a one in four lifetime risk of prostate cancer, the committee found insufficient evidence to recommend screening. Their analysis suggested that annual screening for black men aged 55-60 could lead to 44% of prostate cancers being overdiagnosed, causing unnecessary anxiety and overtreatment.
Health Secretary Wes Streeting stated he would thoroughly examine the evidence and arguments in the draft recommendation. The proposal is now open for a 12-week consultation, with a final decision expected in March.
Prostate cancer is the most common male cancer in the UK, with around 55,300 new cases and 12,200 deaths annually. Despite this, no national screening programme exists due to the unreliability of the PSA test. Charities including Cancer Research UK expressed support for the committee's cautious approach, while others voiced deep disappointment that high-risk groups like black men were not included.
