The UK National Screening Committee (UKNSC) has recommended against offering prostate cancer screening to most men, concluding that widespread use of the prostate-specific antigen (PSA) test is 'likely to cause more harm than good'. The final guidance, submitted to the government, states that population screening would lead to overdiagnosis and unnecessary treatment, causing incontinence and erectile dysfunction in men who do not need intervention.
Prostate cancer is the most common cancer in the UK, with over 64,000 men diagnosed annually, yet there is no national screening programme. The UKNSC's review, launched last year, found that while screening can slightly reduce deaths from prostate cancer, it does not improve overall survival. Chair Prof Sir Mike Richards emphasised that many men 'will live full lives' without the disease causing harm, and current tests cannot reliably distinguish between harmful and harmless cancers.
The committee did recommend targeted screening for men with the BRCA2 gene variant who also have a family history of breast, ovarian, pancreatic, or prostate cancers. These men should be screened every two years between ages 45 and 61, as they face higher risk of aggressive prostate cancer. However, screening was not recommended for other high-risk groups, including black men, due to 'ongoing uncertainty'.
The decision has disappointed campaigners, including Olympic gold-medallist Sir Chris Hoy, former PM David Cameron, and actor Sir Stephen Fry, who have advocated for broader screening. Prostate Cancer UK urged concerned individuals to speak to their GP or use its online risk checker, noting that only about one in 300-400 people carry BRCA variations, though the rate is higher among Ashkenazi Jews.
The UKNSC's final recommendation excludes men with BRCA1 variants, which were included in the draft guidance last November, due to new data showing lower risk. The committee will evaluate over time how to identify and invite eligible patients for screening via the NHS.
