The chairman of the UK's National Screening Committee has publicly revealed his personal experience with prostate cancer for the first time, even as his organisation maintains its position against making screening routinely available to all men.
A Personal Perspective on a Public Decision
Professor Sir Mike Richards, who leads the UK National Screening Committee (UKNSC), disclosed that his own prostate cancer was detected through a PSA (prostate specific antigen) test after he experienced symptoms. Following his diagnosis, Professor Richards underwent surgery to have his prostate removed.
This personal revelation comes amidst significant controversy. The UKNSC, which provides expert advice to the government, recently concluded a review and decided it could not recommend a national prostate cancer screening programme for the general male population. The committee's analysis suggested that such widespread testing might ultimately do more harm than good.
High-Profile Criticism and the Evidence
The decision has drawn criticism from prominent figures, including Olympic cyclist Sir Chris Hoy, broadcaster Sir Stephen Fry, and former Prime Ministers Rishi Sunak and Lord David Cameron. Lord Cameron recently revealed his own prostate cancer diagnosis. These campaigners have united in calling for the PSA test to be made available as part of a national screening programme.
Professor Richards, a former national cancer director, addressed the criticism directly. He explained that while modelling shows population-wide PSA testing could lead to a slight reduction in prostate cancer deaths, this potential benefit is outweighed by the very high levels of overdiagnosis. Many experts question the test's reliability, noting that a high PSA level does not always indicate cancer, and some men with cancer can present with normal PSA results.
When asked by the BBC about facing criticism from two former Prime Ministers, Professor Richards stated: "I may say and I haven't previously said this publicly, I have actually had prostate cancer myself so I do know what it is like from a personal angle as well as through looking at the evidence." He emphasised that his position is not born from opposition to screening in principle, but from a careful interpretation of the current data.
The Path Forward: Research and Targeted Screening
Professor Richards reiterated the review's stark findings, estimating that for every 700 lives saved by screening, 7,000 men could be left with permanent issues such as incontinence and impotence due to unnecessary treatments for slow-growing cancers that may never have caused harm.
The committee's current recommendation is for targeted screening. Men with BRCA1 and BRCA2 genetic mutations, which significantly increase prostate cancer risk, are advised to be screened every two years between the ages of 45 and 61.
Acknowledging that black men are at higher risk, Professor Richards noted a lack of research due to their underrepresentation in past trials. He highlighted a new study, the 'Transform Trial', which is actively recruiting black men to rectify this. He expressed hope for results within two years, stating he would favour changing the recommendations if the evidence supports it.
Meanwhile, experts await data from a large trial launched by Prostate Cancer UK, investigating whether combining the PSA test with other diagnostics like rapid MRI scans could pave the way for a safer, population-wide screening programme in the future. Health Secretary Wes Streeting has said he will consider all findings, balancing the desire for earlier diagnosis with the potential harms of wider screening.
