UK Experts Recommend Against Prostate Cancer Screening for Most Men

The Lead

Most men in the UK will not be offered prostate cancer screening if the government accepts the final recommendation of an expert committee. The UK National Screening Committee (UKNSC) has concluded that widespread screening using the prostate-specific antigen (PSA) test was "likely to cause more harm than good" despite prostate cancer being the most common cancer in the UK.

The Recommendation Details

The committee recommended screening only for men with the BRCA2 gene variant who have a family history of certain cancers, suggesting they be screened every two years between the ages of 45 and 61. For this specific group, prostate cancer is more common, develops earlier, and can be more aggressive. Of 100 men with a BRCA2 variant, between 21 and 35 will develop prostate cancer before the age of 80.

The committee recommended against screening for other at-risk groups, including black men, citing "ongoing uncertainty on whether screening would cause more good than harm." The main harms of population screening include incontinence and erectile dysfunction in men who do not need treatment for the disease.

The Prevalence Data

Prostate cancer is the most common cancer in the UK, with more than 64,000 men diagnosed every year. However, there is currently no national screening programme for the disease. The UKNSC estimates that its final recommendation would lead to "a few thousand" men being screened for prostate cancer each year.

Only around one in every 300 to 400 people will have BRCA gene variations, though as many as one in every 40 Ashkenazi Jewish people carry these variations. In England, the NHS offers free BRCA gene testing for anyone aged 18 or over who has at least one Jewish grandparent.

The Impact Analysis

The decision will come as a blow to campaigners who have voiced support for more widespread screening, including high-profile figures like Sir Chris Hoy, David Cameron, and Sir Stephen Fry. Prostate Cancer UK expressed being "deeply disappointed" with the recommendation, stating that without a screening programme for the UK's most common cancer, "we lose more than 12,000 dads, brothers and partners every single year."

However, medical experts argue that screening can reduce deaths from prostate cancer only to a small extent and does not improve overall survival. The challenge remains that once a prostate cancer is found, doctors still can't reliably tell which cancers need treatment and which do not, and treatments can cause long-lasting harm.

The Future Outlook

The government will now consider the recommendation, with the new Health Secretary James Murray set to meet with the UKNSC chair. The Department of Health and Social Care stated that Murray "will give full and careful consideration to the recommendation" and would update on the government's response shortly.

The committee acknowledged that more research is needed to address evidence gaps, particularly regarding black men. The UKNSC will work with the Transform trial, launched by Prostate Cancer UK, to gather more data. It was noted as "particularly important" that a "sufficient number" of black men be invited to participate in this trial.