Charities Demand Prostate Screening Review Over Flawed Modelling
Charities are calling for the UK government to overrule a decision that denies prostate cancer screening to the vast majority of men, arguing it is based on flawed economic modelling that should be urgently rebuilt. The UK National Screening Committee issued draft guidance in November, recommending routine checks only in very limited circumstances, but an independent review has uncovered significant concerns about the model used to justify this recommendation to ministers.
Flaws in the Screening Model Exposed
Prostate Cancer Research is leading calls for the model to be reconstructed to enable a fairer assessment of screening merits before a final decision is made. The charity commissioned a review by the York Health Economics Consortium, which found the model relied on outdated data, diagnosis methods, and treatments. It also failed to account for the impact of a coordinated screening programme on the UK's existing testing landscape and did not address serious population health inequalities.
Analysis of contemporary MRI-led screening studies suggests the model cited by the UKNSC may have substantially overstated the harms by up to seven-fold. Prostate cancer is the most common cancer in the UK, with 63,000 cases and 12,000 deaths annually, yet unlike breast, bowel, and lung cancers, there is currently no national screening programme.
Current Recommendations and Campaigns
For now, the UKNSC has put forward only a recommendation to screen men with BRCA1 and BRCA2 genetic mutations every two years between ages 45 and 61. It would not recommend population screening using the prostate-specific antigen (PSA) blood test, fearing it may lead to unnecessary biopsies or surgery for tumours that would never cause harm in a lifetime.
However, campaigns like that of the Daily Mail advocate for a national prostate cancer screening programme, initially targeting high-risk men such as those who are black, have a family history of the disease, or specific genetic mutations. High-profile figures including former Prime Minister Rishi Sunak, comedian Stephen Fry, and football World Cup winner Geoff Hurst have all publicly supported such a programme.
Charity Concerns and Calls for Action
Oliver Kemp, chief executive of Prostate Cancer Research, expressed deep concern over the narrowness of the draft recommendations. 'They fail to tackle the harms inherent in the current system and leave men of Black ethnicity and those with relevant family history continuing to rely on current routes for testing,' he said. Kemp emphasised that while screening is not without risk, the current model overly relies on historic data and does not reflect modern NHS practices.
'When contemporary MRI-led pathways and real-world NHS data are considered, projected harms appear substantially lower,' Kemp added. He stressed that this decision will shape prostate cancer early detection policy across the UK for years, making it essential that the modelling framework reflects modern clinical practice and current health inequalities before any final recommendation.
Support from Health Groups and Next Steps
Prostate Cancer Research is supported by over a dozen other charities and health groups, including the Black Prostate Cancer Network, the British Association of Urological Nurses, Prost8 UK, and the Bob Willis Fund, in calling for the modelling to be rerun. Health Secretary Wes Streeting has the authority to overrule the UKNSC, which is due to publish its final recommendation in March.
Kemp concluded, 'We strongly believe the review on this critical issue should be extended to allow time for amendments to the economic model to be made and fully tested. This crucial decision should not be based on a version of screening from decades ago.' The push for a revised model highlights the urgent need to address disparities and improve early detection strategies for prostate cancer in the UK.
