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Prostate Cancer Screening to be Rationed
— 3 mins read
Britain's first prostate cancer screening plan excludes almost every man at risk
The vast majority of men in Britain will not be offered prostate cancer screening. The UK National Screening Committee ruled on Thursday that only men carrying a faulty BRCA2 gene who also have a family history of cancer should be invited for testing.
Eligible men will be offered a PSA blood test every two years between the ages of 45 and 61. Committee chairman Professor Sir Mike Richards said the group might amount to 'a few thousand' men.
Who qualifies and who does not
Only men with a pathogenic BRCA2 gene variant and a family history of breast, ovarian, pancreatic, or prostate cancer are eligible. Draft proposals published in November also included men with BRCA1 variants. The final version dropped them.
Men with a family history alone are also excluded. Sir Chris Hoy, the six-time Olympic champion, announced in 2024 that he was terminally ill with prostate cancer. His father and grandfather both had the disease. A man in his position would still not qualify under the new rules.
The scale of the disease
Prostate cancer is the most common cancer in men in the UK, killing more than 12,000 men a year, according to Prostate Cancer UK. It is the only major cancer without a national screening programme. The UK ranked 17th of 28 countries in one survival league table, though that table used older data, and five-year survival in England now stands at around 89.5%.
Many European countries are piloting or considering some form of screening. But organised national programmes remain rare, and most countries share the same concerns about overdiagnosis, according to analysis published in the BMJ.
We are letting down too many men, their families and loved ones if we don't push for a wider screening programme that includes all high-risk groups.
Richards said the BRCA2 subgroup was 'the only strategy where the UK National Screening Committee had confidence that screening would do more good than harm'. Wider screening risks overdiagnosis and overtreatment, which can cause incontinence and erectile dysfunction. Most men with a high PSA reading do not have cancer.
The committee is a government-supported advisory body. Its decision drew on modelling from the University of Sheffield and a public consultation that received around 1,000 responses. [Minutes of its March meeting] were published this week.
Charities and former prime ministers hit back
Lord Cameron, who was treated for prostate cancer, called the recommendation 'a real step backwards'. He said: 'We are letting down too many men, their families and loved ones if we don't push for a wider screening programme that includes all high-risk groups.'
[Prostate Cancer Research] accused the committee of 'condemning thousands to preventable deaths'. Chief executive Oliver Kemp said men at highest risk 'cannot afford years of delay'.
Chiara De Biase of Prostate Cancer UK said the charity was 'deeply disappointed', while accepting current evidence does not show that screening all at-risk men would do more good than harm.
Rishi Sunak is among 125 MPs urging a wider rollout. He said: 'For just 0.01% of the NHS budget, we could have had a targeted screening programme that would have saved lives.'
What happens next
The recommendation now goes to Health Secretary James Murray, with discussions due on Monday. For now, men without symptoms can request a PSA test from their GP, but doctors cannot proactively offer one. The committee said it hoped new evidence and better tests would support wider screening in future.
