The UK National Screening Committee has rejected calls for widespread prostate cancer screening, recommending tests only for a small group of men with specific genetic mutations. The draft guidance, published Friday, has sparked fierce criticism from cancer charities and politicians who argue thousands of lives could be saved.
The committee's recommendation covers only men aged 45 to 61 who carry BRCA1 or BRCA2 genetic variants - about three in every 1,000 men. These individuals would receive screening every two years. The decision means the vast majority of British men will not have access to routine prostate cancer testing, despite the disease killing 12,000 men annually and affecting 63,000 new patients each year.
The committee concluded that the prostate-specific antigen (PSA) test is "likely to cause more harm than good" for the general population. PSA screening identifies prostate cancers in around 80 percent of men who would not benefit in terms of preventing deaths or advanced disease, according to UKNSC figures.
Backlash from cancer organizations
The decision has met with strong opposition from cancer charities. Laura Kerby, chief executive of Prostate Cancer UK, said: "The committee's decision will come as a blow to the tens of thousands of men, loved ones and families who've fought for a screening programme." However, she described the BRCA recommendation as "It shows that research and evidence can shift the dial and save men's lives."
Oliver Kemp, chief executive of Prostate Cancer Research, called the decision a "missed opportunity" for high-risk groups. "We are failing these groups and entrenching inequalities further by not providing them with the best chance of having their disease caught early – when they are more likely to survive," he stated.
The committee specifically declined to recommend screening for Black men - who face double the risk of prostate cancer - or men with a family history of the disease, citing a current lack of data and evidence.
Political pressure mounts
Health Secretary Wes Streeting faces significant pressure to potentially overrule the committee's recommendation. More than 120 MPs, including former Prime Minister Rishi Sunak, delivered a letter this week describing a screening program as a "legacy-defining advance for men's health".
Former Conservative Prime Minister David Cameron added his voice after revealing his own prostate cancer diagnosis last Sunday. "I don't particularly like discussing my personal intimate health issues, but I feel I ought to," Cameron told The Times. "Let's be honest. Men are not very good at talking about their health. We tend to put things off."
Streeting told MPs he would "examine the evidence and arguments in this draft recommendation thoroughly, bringing together those with differing views, ahead of the final recommendation in March". He emphasized balancing earlier diagnosis against "the harms that wider screening could cause to men".
The screening debate
The committee's reasoning centers on the PSA test's limitations. The test can produce false positives - 75 percent of men with raised PSA levels do not have cancer - and false negatives, missing approximately 15 percent of cases. Treatments for detected cancers can cause severe side effects including incontinence and erectile dysfunction, raising concerns about overtreatment of slow-growing tumors that might never become life-threatening.
However, recent research from the University of Oxford examining over 10 million men's health records suggests screening could prevent deaths. US National Cancer Institute guidance estimates that for every 1,000 men aged 55 to 69 screened for 13 years, up to two deaths from prostate cancer would be avoided.
Professor Ros Eeles of the Institute of Cancer Research highlighted the particular urgency for BRCA carriers. "Men with the BRCA1 gene fault are more than three times as likely, compared with non-carriers, to have aggressive prostate cancers that are likely to grow and spread quickly," she stated. She also noted that "if you stop screening at 61 years of age, you miss nearly half of all cancers" for BRCA carriers between 40 and 69 years.
The draft recommendations will undergo a 12-week public consultation period. The government has funded Prostate Cancer UK's £42 million Transform trial, which combines PSA tests with MRI scans and genetic tests. Results are expected within two years and could reshape future screening policy.
Note: This article was created with Artificial Intelligence (AI).
