The UK National Screening Committee has published a draft recommendation proposing a targeted screening programme for Prostate cancer, but only for a small, high‑risk group of men. Under the draft plan, men aged 45 to 61 who carry confirmed variants of the BRCA1 or BRCA2 genes would be invited for prostate cancer screening every two years.
The committee has, at the same time, recommended against a general population screening programme. It also chose notto endorse targeted screening for other high‑risk groups — including men of Black ethnicity or men with a family history of prostate cancer.
This decision follows a rigorous expert review and modelling of existing evidence, which weighed both the potential benefits and harms of screening. The concerns cited included the limitations of the commonly used prostate‑specific antigen (PSA) test: false positives and negatives, difficulty distinguishing slow‑growing cancers (which may never cause harm) from aggressive ones, and the risk of overdiagnosis leading to unnecessary investigations or treatment.
According to the modelling, focusing screening on men with BRCA mutations offers the best balance of benefit and harm. In this group, early detection is more likely to identify fast‑growing cancers in time for effective intervention, while reducing the chance of overdiagnosing indolent disease that would not threaten health.
The draft recommendation is now open for a 12‑week public consultation. Meanwhile, the UK is undertaking a major new trial — TRANSFORM screening trial — to further evaluate screening strategies. The committee has indicated it will continue to work with the trial team and monitor emerging data before finalising any policy.
The UK records around 55,000 new prostate cancer cases and 12,000 deaths each year, highlighting the scale of the disease nationally.
As the consultation proceeds and new evidence emerges, the UK health system faces an important decision about how best to balance early detection with the risks of overdiagnosis and overtreatment in prostate cancer care.
