The UK National Screening Committee (UKNSC) has advised against a national screening programme for prostate cancer, concluding that widespread testing using the prostate-specific antigen (PSA) test is 'likely to cause more harm than good'. Prostate cancer is the most common cancer in UK men, with over 64,000 diagnoses annually, but no current screening programme exists.
The committee's final recommendation to the government, released after a review launched last year, states that population screening would lead to overdiagnosis and unnecessary treatment, causing harms such as incontinence and erectile dysfunction. While screening can reduce prostate cancer deaths to a small extent, it does not improve overall survival, according to UKNSC chair Prof Sir Mike Richards.
The committee recommended screening only for men with the BRCA2 gene variant who also have a family history of breast, ovarian, pancreatic or prostate cancers. These men should be offered PSA tests every two years between ages 45 and 61. The decision excludes other high-risk groups, including black men and those with BRCA1 variants, due to insufficient evidence of benefit.
The recommendation is a setback for campaigners including Sir Chris Hoy, David Cameron and Sir Stephen Fry, who have advocated for wider screening. Prostate Cancer UK advises concerned individuals to speak to their GP about BRCA testing, noting that around one in 300-400 people carry these gene variations, rising to one in 40 among Ashkenazi Jews.
Prof Sir Mike Richards acknowledged strong public support for screening but emphasised the difficulty in distinguishing between harmful and harmless prostate cancers. 'Once a prostate cancer is found, we still can’t reliably tell which cancers need treatment and which do not,' he said, noting that treatments can cause long-lasting harm.
