The UK National Screening Committee (UK NSC) decision falls short of targeted screening recommendation

For years, Prostate Cancer Research has been campaigning hard for the introduction of a national prostate cancer screening programme, starting with those at highest risk – including men aged 45–70 who are Black, have a family history of prostate, breast or ovarian cancer, or carry a BRCA1 or BRCA2 gene variant.

Today the UK NSC published their draft recommendation that only those men who carry a BRCA1 or BRCA2 gene variant will be offered screening. This is a huge opportunity missed. We are profoundly concerned that other high-risk groups have been left behind. Men, their families and our communities deserve so much better than this.

We agree that screening must be guided by robust evidence. But the reality is clear; the evidence has evolved, the harms caused by unnecessary tests and diagnostic procedures have fallen, and the analysis underpinning today’s decision does not reflect modern practice. We cannot wait another decade while thousands more men are diagnosed too late.

• Screening saves lives. Landmark trials such as Göteborg and ERSPC show substantial, long-term reductions in deaths when men are invited for PSA-based screening. They have shown that the number of men needed to be screened to save one life is in line with other established screening programmes, such as breast cancer.[i] [ii]
• The harms have changed dramatically. Modern MRI-first diagnostic pathways halve overdiagnosis, dramatically reduce unnecessary biopsies, and cut biopsy-related infections by up to 90% in NHS practice.[iii] [iv]
• This is about using existing resources better. The NHS already pays for large volumes of opportunistic PSA testing – but without the safeguards of a structured pathway, this is ineffective, inconsistent and inequitable. A targeted programme would make better use of current spend without that much additional investment.
• Targeted screening is practical and affordable. Independent modelling for PCR shows a targeted programme would cost around £25m a year – just 0.01% of the NHS budget – with modest workforce demands and costs comparable to existing screening programmes.[v]
• The economic case is compelling. Analysis for PCR by Deloitte UK shows a targeted programme would generate £54m in net socio-economic benefit, thanks to, amongst other things, earlier treatment.[vi]
• Inequalities are worsening. The National Prostate Cancer Audit (2025) shows that inequalities are widening, not narrowing. Black men and men in more deprived areas remain far more likely to be diagnosed late and die from prostate cancer and doing nothing is not a neutral choice.[vii]
• The UK is falling behind international progress. Sweden’s Organised Prostate Testing (OPT) programme shows that structured, equitable testing is achievable even without a formal screening programme, providing a clear pathway towards national rollout. [viii] Across Europe, the EU is already moving ahead with its prostate cancer screening recommendation, and Australia is preparing to update national guidelines to endorse risk-adapted testing for high-risk men.[ix] [x] The UK risks being left behind unless decisive action is taken now.

By excluding Black men and those with a family history – groups who face some of the highest risks in the country – this decision risks entrenching health inequalities for another generation.

We urge the Government and the UK NSC to reassess the evidence urgently and ensure that screening is extended to all high-risk men. Every year of delay means more men being diagnosed late, more avoidable deaths, and a widening gap in outcomes across communities.

Prostate cancer is the most common cancer in men in the UK. We know how to find it earlier, diagnose it more safely, and save more lives. Those at highest risk should not be asked to wait.

But this is not the final word. The Government can still act.

We will not stop until high-risk men get the early diagnosis they deserve.

[i] Hugosson J, Månsson M, Wallström J et al. Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only. N Engl J Med. 2022 Dec 8;387(23):2126-2137. doi: 10.1056/NEJMoa2209454.

[ii] Roobol MJ, de Vos II, Månsson M, et al. European Study of Prostate Cancer Screening – 23-Year Follow-up. N Engl J Med. 2025 Oct 30;393(17):1669-1680. doi: 10.1056/NEJMoa2503223

[iii] Norori N, Burns-Cox L, Blaney N et al. Using real world data to bridge the evidence gap left by prostate cancer screening trials, ESMO Real World Data and Digital Oncology, Volume 6, 2024, 100073, ISSN 2949-8201, doi: 10.1016/j.esmorw.2024.100073

[iv] Hugosson J, Månsson M, Wallström J et al. Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only. N Engl J Med. 2022 Dec 8;387(23):2126-2137. doi: 10.1056/NEJMoa2209454.

[v] Prostate Cancer Research. Prostate Cancer Screening: Impact on the NHS; 2025.

[vi] Prostate Cancer Research. Socio-Economic Impact of Prostate Cancer Screening; 2024.

[vii] National Prostate Cancer Audit (NPCA) State of the Nation Report October 2025. London: National Cancer Audit Collaborating Centre, Royal College of Surgeons of England, 2025.

[viii] Bratt O, Godtman RA, Jiborn T et al. Population-based Organised Prostate Cancer Testing: Results from the First Invitation of 50-year-old Men. Eur Urol. 2024 Mar;85(3):207-214. doi: 10.1016/j.eururo.2023.11.013.

[ix] EU Council Recommendation 2022/2381 and Beating Cancer Plan updates (2024). consilium.europa.eu/en/press/press-releases/2022/12/09/council-updates-its-recommendation-to-screen-for-cancer/

[x] Prostate Cancer Foundation of Australia, Public Consultation: Draft 2025 Clinical Guidelines for the Early Detection of Prostate Cancer. pcfa.org.au/public-consultation/