The most common cancer in England still has no screening for men at highest risk. The rules have got to change
28 March 2025, 08:19 | Updated: 28 March 2025, 10:10
Over 50,000 men are diagnosed with prostate cancer every year in the UK, yet there is still no national screening programme.
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Dads. Brothers. Sons. Mates. Nearly all of us know someone who has heard the words “you have prostate cancer”. Too many of us have lost that person.
And cases continue to rise. The most common cancer in men recently became the most common cancer in England, with the number of diagnoses surpassing those of breast cancer for two years in a row and shooting up by a quarter between 2019 and 2023.
Despite this, prostate cancer still has no national screening programme and GPs remain bound by outdated NHS guidance that fails men at highest risk.
The earlier you find prostate cancer, the easier it is to treat. But most men with early prostate cancer don’t have any signs or symptoms.
However, NHS guidelines today stop GPs from proactively discussing the PSA blood test (the best first step to finding signs of prostate cancer) with the men who are most likely to get it- including Black men, who are at double the risk of white men, and men with a family history of the disease, like Sir Chris Hoy- unless they present with symptoms.
Faced with this situation, it is each man’s responsibility to find out his risk and start a conversation with a GP. This relies on men knowing they have a prostate, knowing their risk of prostate cancer and then asking for a PSA blood test. It puts all the responsibility onto men, some of whom may not be comfortable discussing their health. It puts those who are less confident, less literate, have less time or are less trusting of our health system at an unfair disadvantage. It entrenches divisions like the North-South divide and further excludes marginalised groups.
With many agreeing they are outdated, there are also huge inconsistencies in how these guidelines are applied. Some GPs roll out programmes for community testing to increase earlier diagnosis, whilst others reject requests for PSA blood tests when no symptoms are shown. Fortunately, many GPs and clinicians are applying common sense and giving men informed choice, acknowledging that men can and should participate in their own health. But men deserve much more consistency in their care, and the rules that govern this must be mandated by those in power.
Prostate Cancer UK has been calling for an overhaul of the guidelines for many years, and now we need the Government to step up and take action. We urgently need an early detection programme for prostate cancer which makes the system clearer, fairer, consistent and more equitable for all.
Last year, we published research that showed prostate cancer diagnosis is safer and more accurate than ever before, in part thanks to research we funded that led to MRI being introduced into the diagnostic pathway. We have also led a consortium of men’s health charities to collectively challenge the National Screening Committee (NSC) to implement targeted screening for those at highest risk. Screening is complex, but we believe the evidence is there now for those at highest risk. We urgently await the outcome of their decision.
However, there is something the Government can do right now to save men’s lives. They can update NHS guidelines so GPs can proactively start conversations about prostate cancer with men at highest risk from the age of 45, providing clear, up-to-date health information and discussing the pros and cons of the quick, simple, and free PSA blood test.
We’ve had nearly 10,000 supporters sign our letter to Secretary of State Wes Streeting calling for him to act, and it’s been raised by MPs in the House of Commons. We remain fierce advocates for men, and every day that passes without this simple change being made is a day men are being failed by the system that should be protecting them. It’s about time for a change.
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Laura Kerby is the CEO of Prostate Cancer UK.
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