The UK National Screening Committee (UKNSC) has advised against introducing a national prostate cancer screening programme for most men, concluding that widespread testing using the prostate-specific antigen (PSA) test is 'likely to cause more harm than good'. The final recommendations, submitted to the government, cite risks of incontinence and erectile dysfunction from unnecessary treatment.
Prostate cancer is the most common cancer in the UK, with over 64,000 diagnoses annually, but no national screening currently exists. The UKNSC reviewed new evidence and determined that while screening can slightly reduce deaths, it does not improve overall survival and leads to overdiagnosis of harmless cancers.
The committee recommended targeted screening every two years for men aged 45 to 61 who carry the BRCA2 gene variant and have a family history of breast, ovarian, pancreatic, or prostate cancers. This group faces a higher risk of aggressive prostate cancer. However, screening was not advised for other at-risk groups, including black men, due to 'ongoing uncertainty' about benefits.
Professor Sir Mike Richards, chair of the UKNSC, acknowledged strong public support for screening but emphasised the harms of treating cancers that may never cause symptoms. He noted that current methods cannot reliably distinguish between harmful and harmless prostate cancers, even with advances like MRI scans.
The decision has disappointed campaigners such as Sir Chris Hoy, David Cameron, and Sir Stephen Fry. Prostate Cancer UK urged concerned individuals to speak to their GP and highlighted that only about one in 300 to 400 people carry BRCA gene variations, though the rate is higher among Ashkenazi Jewish people.
The UKNSC will evaluate how to identify and invite eligible BRCA2 carriers for screening in partnership with the NHS. The government will consider the recommendations before making a final decision.
