On 28th November 2025, the National Screening Committee (UK NSC) published their draft recommendation that only those men who carry a BRCA1 or BRCA2 gene variant will be offered prostate cancer screening.
As a charity dedicated to giving men a better chance of beating prostate cancer through raising awareness and PSA testing, we believe this is the wrong decision.
In his letter to The Times (20/12/25), co-authored with Prof Frank Chinegwundoh (St George’s, University of London), Prostate Project trustee Prof Stephen Langley wrote:
“Sir, If the National Screening Committee fails to recommend the introduction of a targeted screening programme, for men at the highest risk of prostate cancer, they will have made a grave and inequitable mistake (“Screening every man for prostate cancer isn’t as helpful as it sounds” Oct 18). Black men, and those with a family history of the disease, face a significantly higher risk. To treat these men the same as the low-risk population is not evidence-based prudence, it is clinical negligence.
The narrative that the PSA blood test is a blunt and harmful instrument is a decade out of date. Today, an elevated PSA test is not a ticket to an immediate biopsy, it’s the start of a far more sophisticated diagnostic pathway. Furthermore, the UK is a world leader in minimising overtreatment. Approximately 90% of men diagnosed with low-risk prostate cancer are now managed with active surveillance, a strategy that reserves radical treatment for life-threatening cancer only.
The recent Lancet Commission on prostate cancer unequivocally emphasises the need to expand testing in high-risk groups. While we wait for the perfect test to merge, we must use the tools we already have to save thousands of lives”.
Excluding screening for those at high risk (particularly black men and those with a family history), we think will deepen health inequalities. The National Prostate Cancer Audit (2025) showed black men and men in more deprived areas remain far more likely to be diagnosed late and die from prostate cancer.
The NSC has opened a 12-week public consultation period. We hope that following this consultation, the Government will reassess the evidence and extend prostate cancer screening to all high-risk men.
We think that there is enough evidence to support the introduction of a national prostate cancer screening programme.
Across Europe, the EU is already moving ahead with its prostate cancer screening recommendation and in December 2022 the Council of the EU officially adopted a new recommendation on cancer screening.
The suggested screening algorithm involves PSA testing, in combination with magnetic resonance imaging (MRI) scanning as a follow-up to manage the risk of over diagnosis and overtreatment; with over- diagnosis halved, unnecessary biopsies reduced, and biopsy-related infections reduced by up to 90% in NHS practice.
Independent modelling for Prostate Cancer Research (PCR) shows a targeted programme would cost around £25m a year, just 0.01% of the NHS budget, and analysis for PCR by Deloitte UK shows a targeted programme would generate £54m in net socio-economic benefit, due to earlier treatment
Public consultation
The NSC has opened a 12-week public consultation period to ask individuals and organisations to provide feedback on this study and its conclusions, and on the draft recommendation below:
To take part in the consultation, please download the consultation documents by clicking on the grey ‘View documents’ button on the UK NSC’s prostate cancer recommendation page. Deadline is Friday 20th February 2026.
Draft recommendation
The UK NSC’s draft recommendation is to:
- Offer a targeted national prostate cancer screening programme to men with confirmed BRCA1 or BRCA2 gene variants every 2 years, from age 45 to age 61
- Not recommend population screening
- Not recommend targeted screening of Black men
- Not recommend targeted screening of men with family history
- Collaborate with the Transform screening research trial team to:
- Answer outstanding questions on screening effectiveness for black men and men with a family history as soon as trial data becomes available
- Await results of the study to develop and trial a more accurate test than PSA alone, to improve the balance of benefit and harm of screening
The 2025 modelling study
The updated 2025 SCHARR model has been informed by published peer-review evidence, national databases, input from experts and patient representatives, and workshops attended by a wide range of stakeholders.
The model has been validated against data from 2 major, long-term, randomised controlled trials into the effectiveness and harms of using PSA testing to screen for prostate cancer 1. The Cluster Randomised Trial of PSA Testing for Prostate Cancer (CAP) and 2. The European Randomised Study of Screening for Prostate Cancer (ERSPC).
The model assumes the PSA test is the initial test for all screening strategies followed by further tests, such as an MRI scan and biopsy, if the PSA level is high. It assessed each screening strategy for a one-off screening test. If that looked likely to be effective, the researchers also modelled regular repeat screening test scenarios.
The TRANSFORM trial
The UK NSC worked with Prostate Cancer UK on the design of the TRANSFORM screening trial. Last week it was announced that the first men have been invited to join the trial. This randomised control trial, backed by £42 million of funding from Prostate Cancer UK and the government, will compare multiple screening options to each other and the current system.
The trial is aimed at finding the best way to detect the disease by comparing it to current NHS diagnostic practices, which can include blood tests and biopsies. It could help shift the evidence in favour of screening in as little as two years if the committee decides against a national rollout.
The NCS will liaise closely with the trial team to get timely access to any trial data that might help fill evidence gaps and inform future modifications to the UK NSC’s prostate cancer screening recommendation.
What can you do to help?
- Please take part in the consultation by visiting the Government website here
- You can also sign the petition created by our good friends at Prostate Cancer Research
- And please contact your MP, asking that they show their support to the call for a national screening programme.
