Prostate cancer is set to remain the only major cancer in the UK without a national screening programme, following a pivotal recommendation from government advisers.
The National Screening Committee, a body comprised of leading doctors and economists, has concluded that the potential harms of screening all men in their 50s and 60s currently outweigh the benefits. This decision, announced on Friday 28 November 2025, means the NHS is unlikely to implement mandatory screening for men over 45.
The Core Problem with a Blanket Approach
Instead of a nationwide programme, the committee will advise screening only for the approximately one in 260 men who carry the inherited BRCA cancer gene. Men with this mutated gene face a significantly higher risk, with one in three likely to develop an aggressive form of prostate cancer.
However, a major flaw in this targeted plan is that many men may be completely unaware they carry the gene. Awareness typically only arises if a female relative, such as a mother or sister, developed breast or ovarian cancer at a young age and subsequently had genetic testing. Male relatives are often left in the dark, unaware of the implications for their own health and the need for BRCA testing and subsequent prostate screening.
The Pitfalls of the PSA Test
The primary tool for prostate screening is the PSA blood test. While it can flag the potential presence of cancer, it has significant limitations. Crucially, the PSA test does not determine whether a detected cancer is aggressive and life-threatening.
This ambiguity can lead to a difficult dilemma: some men may undergo risky and unnecessary treatments for slow-growing cancers that would never have caused them harm. It is this balance of potential over-treatment against the benefits of early detection that has made the committee cautious.
Campaigners Push for a Broader Definition of High-Risk
The committee's draft recommendations are now entering a public consultation phase, where charities and campaigners are expected to lobby vigorously for a more inclusive approach to screening.
They argue that targeting other high-risk groups could circumvent the challenges of BRCA testing. For instance, Black men face twice the risk of prostate cancer compared to the general population. Additionally, men with a close relative who had prostate, breast, or ovarian cancer at a young age could be proactively included.
Cases like that of Olympian Sir Chris Hoy, who was diagnosed with advanced prostate cancer despite having a known family risk, powerfully illustrate the argument for more comprehensive targeted screening.
While the National Screening Committee remains unconvinced for now, the final decision rests not with them but with the Health Secretary, Wes Streeting. After the consultation concludes, Mr. Streeting will make the ultimate call, a decision that will undoubtedly be informed by both medical evidence and political sensitivity.
