The NHS has decided against introducing mass population screening for prostate cancer, meaning men will not be proactively invited for PSA blood tests based on age alone. This move follows the UK National Screening Committee's recommendation that the prostate-specific antigen (PSA) test should only be routinely offered to men with the BRCA gene mutation that significantly increases their cancer risk.
Current PSA Testing Guidelines
Despite the absence of a national screening programme, men can still access PSA testing through their GP under specific circumstances. Doctors may suggest the test if patients report potential prostate cancer symptoms including frequent urination, sudden urges to pee, nighttime waking to urinate, blood in urine, or erectile difficulties.
Men aged 50 or over can request a PSA test even without symptoms, though campaigners argue many aren't aware of their eligibility. Those with a family history of prostate cancer can also request testing from age 50.
Why PSA Testing Remains Controversial
The screening debate continues because 75% of people with elevated PSA levels don't have prostate cancer. Levels can rise for various reasons including simple infections, potentially leading to unnecessary biopsies, MRI scans, or treatment for harmless tumours.
Equally concerning, the test can miss aggressive cancers, with evidence suggesting around 15% of people with normal results actually have prostate cancer. Olympic cycling champion Sir Chris Hoy, who received a terminal prostate cancer diagnosis, is among prominent figures arguing that men with known risk factors should receive automatic testing invitations once they reach certain ages.
New Recommendations for High-Risk Groups
If the government confirms the screening committee's recommendations next year, men with the BRCA gene mutation could be invited for routine PSA testing. Those suspecting family members carried the BRCA mutation can request NHS genetic testing using blood or saliva samples.
Professor Freddie Hamdy, a leading prostate surgeon and committee adviser, emphasizes the importance of distinguishing relevant family history. "We would have someone come in his early 50s and he says his father had prostate cancer and had surgery. Or 'my father had prostate cancer and he's on hormone therapy now'. That is a serious family history," he explained, contrasting this with cases where relatives developed prostate cancer in old age and died from unrelated causes.
The PSA test itself involves a simple blood draw, usually performed at local hospitals or GP surgeries. Men are advised to avoid strenuous exercise for 48 hours beforehand as physical exertion can temporarily elevate PSA levels and affect result accuracy.
