A government-appointed expert committee has recommended against widespread prostate cancer screening for most men in the UK, concluding that the potential harms outweigh the benefits. The UK National Screening Committee (UKNSC) released its final recommendations, stating that population-based screening using the prostate-specific antigen (PSA) test is "likely to cause more harm than good."
Limited Screening for High-Risk Groups
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 screened every two years between ages 45 and 61. Of 100 men with a BRCA2 variant, 21 to 35 will develop prostate cancer before age 80. The committee excluded men with BRCA1 variants from the final recommendation due to new data showing significantly lower risk.
Other at-risk groups, including black men, were not recommended for screening due to "ongoing uncertainty on whether screening would cause more good than harm." The main harms include incontinence and erectile dysfunction in men who do not need treatment.
Reaction from Campaigners and Experts
The decision disappoints campaigners such as Sir Chris Hoy, David Cameron, and Sir Stephen Fry, who have supported wider screening. Prof Sir Mike Richards, chair of the UKNSC, acknowledged the strong support but emphasized that screening can only reduce deaths to a small extent and does not improve overall survival. He noted that once prostate cancer is found, doctors cannot reliably distinguish between harmful and harmless disease, leading to overdiagnosis and unnecessary treatment.
Prostate Cancer UK expressed deep disappointment, noting that over 12,000 men die from the disease annually. The charity recommends that worried individuals speak to their GP and offers a 30-second online risk checker. For those with Ashkenazi Jewish ancestry, the NHS provides free BRCA gene testing for anyone aged 18 or over with at least one Jewish grandparent.
Next Steps
The government will consider the recommendation, with Health Secretary James Murray meeting Richards on Monday. The Department of Health and Social Care said Murray will give "full and careful consideration" and update on the response shortly. The UKNSC estimates its recommendation will lead to a few thousand men being screened annually. It will also work with the Transform trial, launched by Prostate Cancer UK, to gather more data, particularly from black men.
Freddie Hamdy, professor of urology at the University of Oxford, advised any worried man to discuss prostate cancer with their GP. Dr Ian Walker of Cancer Research UK urged the government to accept the recommendation, emphasizing that screening decisions must be guided by evidence where benefits outweigh harms.
