A Letter on the Urgent Need for Targeted Prostate Cancer Screening

Ahead of the UK National Screening Committee’s decision on prostate cancer screening, Prostate Cancer Research worked closely with MPs from all parties to bring this joint letter together. Signed by over 120 parliamentarians, it calls on the Health Secretary to be ready to act on prostate cancer screening and to end the delays that are costing men their lives. A copy of the letter and signatories can be found below.

Photo credit: Agata Noweta

The Rt Hon Wes Streeting MP
Secretary of State for Health and Social Care

24 November 2025

Dear Secretary of State,

We write united by a belief that no man should die because of his postcode, ethnicity, or GP access.

Prostate cancer is now the most common cancer in UK men, with over 63,000 diagnoses and 12,000 deaths annually (i). This week, the UK National Screening Committee (UK NSC) meets to decide on prostate cancer screening. This is a defining moment for men’s health. The Government must be ready to act so that those at highest risk – men aged 45–69 who are Black, have a family history of prostate, breast or ovarian cancer, or carry BRCA1/BRCA2 variants, all of whom face at least twice the average risk of developing prostate cancer – are no longer left behind (ii).

1) A growing inequity
The latest National Prostate Cancer Audit (2025) shows inequalities are deepening. Men in deprived areas are more likely to present with advanced disease and more likely to die (iii). Our current opportunistic PSA testing system is unstructured, inefficient and unfair – a postcode lottery where some men succeed because they know to ask or can pay privately, while others are turned away despite repeated requests.

Yet the data hide what cannot be modelled: eroded trust among communities who feel abandoned. Black men, already at higher risk, often believe the system fails them. Families bear devastating emotional and financial burdens from late-stage disease – costs absent from formal modelling but among the most compelling reasons to act.

2) The evidence is now clear
The evidence shows screening saves lives. The 23-year follow-up of the European Randomised Study of Screening for Prostate Cancer demonstrated a 13% mortality reduction – comparable to breast and bowel screening, with the numbers needed to screen and treat to prevent a death in line with those for existing programmes (iv,v).

Modern diagnostic pathways have transformed safety. Prostate Cancer UK’s 2024 analysis found harms reduced by 79% thanks to MRI and improved biopsy techniques (vi). The Göteborg-2 trial confirmed pre-biopsy MRI halves overdiagnosis (vii).

Today, the pathway is entirely different to when the UK NSC last evaluated screening: men have an MRI before any biopsy is considered; biopsies are carried out using safer transperineal methods; and low-grade cancers are far less likely to be detected – and, when they are, they are managed with active surveillance rather than treatment. Harms that once justified inaction have largely been engineered out.

These advances mean we now have the tools to deliver screening safely and effectively, yet the system is frozen waiting for next-generation trial data. Comments in The Times (3 October) suggest results from the upcoming TRANSFORM trial may take over a decade (viii). Waiting would entrench inequality and allow preventable deaths. Evidence is strong enough to act now. Perfection must not be the enemy of progress.

3) Practical, affordable and efficient
Targeted screening is practical and affordable. Prostate Cancer Research’s 2025 report, Prostate Cancer Screening: The Impact on the NHS, with modelling by Carnall Farrar, shows additional annual costs would be around £25m – just 0.01% of the NHS budget – with modest workforce uplift and costs per screen comparable to existing programmes (ix). Recent data also show a simplified MRI, taking 10 minutes, is as effective as current scans, opening the path to increased capacity within existing resources (x).

The socio-economic benefits are substantial. Deloitte UK modelling found a five-year targeted programme would deliver a net benefit of £54m through earlier diagnosis, reduced treatment costs, and quality-of-life gains (xi). Late stage treatment averages £127,000 per patient vs £13,000 for early-stage (xii). Every delay costs lives and money.

Public support is overwhelmingly behind action: a nationally representative Healthwatch England poll of 3,575 men found 79% would attend screening if invited (xiii). Tens of thousands have called on Parliament to act. We have a duty to listen, and to act.

4) Learning from the world
The UK can lead but risks falling behind. Sweden’s Organised Prostate Testing (OPT) programme shows that structured, equitable testing is achievable even without a formal programme, laying the groundwork for a future national rollout (xiv). Across Europe, the EU is implementing its prostate cancer screening recommendation, and Australia is preparing to endorse risk adapted testing for high-risk men (xv, xvi).

Introducing targeted screening would be a legacy-defining advance for men’s health, aligned with the ambitions of the Men’s Health Strategy and the National Cancer Plan.

Yours sincerely,