What the new prostrate cancer screening recommendation means for you

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More than 63,000 men are diagnosed with prostate cancer annually in the UK

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The UK National Screening Committee (UK NSC) has rejected calls for population-wide prostate cancer screening using the PSA test.

What is prostate cancer?

More than 63,000 men are diagnosed with prostate cancer annually in the UK, with over 12,000 dying from the disease each year, according to Prostate Cancer UK.

The prostate is a gland located next to the bladder, primarily functioning to help produce semen.

While early prostate cancer often presents no symptoms, later stages can include changes in urinary habits, such as a weak flow or needing to go more often.

Other indicators include blood in the urine or semen, pain in the back, pelvis or hips, unexplained weight loss, and erectile dysfunction.

Many cases progress too slowly to cause problems or early death, but some cases are very aggressive.

Who is at higher risk?

Most cases of prostate cancer are in men over the age of 65 and risk goes up with every year.

Black men have double the risk of prostate cancer.

Any man with a family history of the disease is also at increased risk and men with a brother or father diagnosed with prostate cancer have two to four-fold greater risk of developing prostate cancer.

The BRCA2 gene mutation is linked to a higher chance of developing prostate cancer at a younger age and in a more aggressive form.

Of 100 men with a BRCA2 variant, between 21 and 35 of them will develop prostate cancer before the age of 80.

Why is screening so controversial?

Evidence suggests PSA levels can rise for many reasons, including simple infections, and 75% of people with a raised PSA do not have prostate cancer.

A raised level means men can be referred for unnecessary biopsies or MRI, or treated for tumours that may never cause harm.

The PSA test can also miss aggressive cancer. Evidence has suggested around 15% of people with a normal result may actually have prostate cancer.

What do researchers say?

A large study this year concluded that prostate cancer blood tests can lead to men being over-tested, while those who need help may be missed.

Researchers from the University of Oxford examined the health records of more than 10 million men in England and found that many patients are being given prostate specific antigen (PSA) tests much more frequently than recommended.

Repeat testing is also occurring in patients without symptoms, or whose previous tests suggest low levels of risk, according to the study.

Experts also said that celebrities sharing their cancer journeys and advocating for PSA tests is leading to a rise in requests for testing.

Prostate Cancer Research has been calling for a programme targeting men aged 45 to 69 who have a family history of the disease, and black men.

This would cost about £25 million each year or £18 per person. The charity has said the benefits would outweigh the costs.

The US National Cancer Institute has published guidance estimating that, for every 1,000 men aged 55 to 69, who are screened for 13 years, only up to two deaths from prostate cancer would be avoided.

Experts tend to agree more research is needed and the Transform trial launched by Prostate Cancer UK, which is expected to have results in two years, could provide answers.

What is the new recommendation?

The new recommendation from the UK NSC, which is subject to consultation, is for a targeted screening programme every two years for men with a confirmed BRCA1 and BRCA2 genetic variant, from age 45 to age 61.

The UK NSC said it did not recommend screening for black men for prostate cancer - who are at higher risk - because of a current lack of data and evidence.

The committee also does not recommended targeted screening for men with a family history of the disease, who are also at higher risk of prostate cancer.

The UK NSC said it will work closely with the Transform trial launched earlier in November by Prostate Cancer UK to gather more data in these areas.

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