The Health Secretary has confirmed that thousands more Black men will be invited to participate in a prostate cancer screening trial, as he reiterated his commitment to "following the science" by not endorsing population-wide testing.
Targeted Screening for High-Risk Groups
James Murray accepted a recommendation from the UK National Screening Committee (UKNSC), which will see only a few thousand men with specific high-risk gene mutations screened for the disease. However, he simultaneously announced funding to broaden the Transform trial, an initiative exploring optimal testing methods, to specifically include a greater number of Black men.
Last week, the UKNSC advised against screening all men using the prostate specific antigen (PSA) blood test, concluding it was "likely to cause more harm than good." Instead, the new guidance targets men with BRCA2 genetic mutations – a group at significantly elevated risk of prostate cancer. These individuals will undergo testing every two years between the ages of 45 and 61, provided they have a family history of breast, ovarian, pancreatic, or prostate cancers.
BRCA2 Mutation and Prostate Cancer Risk
Prostate cancer is known to be more prevalent, develop earlier, and present more aggressively in men with the BRCA2 variant. Statistics indicate that between 21 and 35 out of every 100 men with this mutation will develop prostate cancer before reaching 80 years of age. Consequently, it is projected that this targeted approach will lead to a "few thousand" men being screened annually.
Dr Ian Walker, director of policy at Cancer Research UK, said the decision will be "disappointing for some" but is in line with evidence as there is some debate over the reliability of the PSA test. The UKNSC also recommended against screening for other at-risk groups, including Black men, saying there is "ongoing uncertainty on whether screening would cause more good than harm."
Investment in Research and Treatment
Mr Murray accepted the recommendations on Tuesday, but announced a £20 million investment into prostate cancer research and treatment. This includes funding to expand the Transform trial. It is estimated that one in 10 patients invited to take part in stage one of the study were Black. For stage two of the trial, Black men living in the UK aged between 45 and 74 will be eligible, as long as they have not had a PSA test or MRI scan in the last five years. The programme is expected to be rolled out in 2027.
Nick Jones, founder of Soho House and a prostate cancer survivor and campaigner, accused the Government of accepting a recommendation that "entrenches" injustices. He said: "The current system is unfair and behind the times. Instead of addressing that injustice, the Government has simply accepted a recommendation that entrenches it. Campaigners and community representatives have been trying to engage with the UKNSC for months and have been dismissed. To rubber-stamp this recommendation into Government policy is not caution – it is a dereliction of duty that will cost lives."
Government Response
Mr Murray said: "This is a major step forward in how we tackle prostate cancer – focusing on those most at risk, improving the treatments available and backing the research we need to close the evidence gaps and save lives. We're following the science to make sure men get earlier answers and better care, and to avoid doing unnecessary harm. By investing in research through trials such as Transform, we're building a fairer, more effective prostate cancer screening system for the future."
Deputy Prime Minister David Lammy said: "Tackling prostate cancer is personal for me. I've got two brothers living with the disease, and I've seen first-hand the toll it takes on individuals and their loved ones. Helping more Black men take part in this research is about saving lives, closing deadly inequalities and making sure we understand what works best for those most at risk."
Support from Charities and Criticism
Laura Kerby, chief executive at Prostate Cancer UK, which is behind the Transform trial, described the funding announcement as a "truly historic moment." She said: "Black men are twice as likely to get the disease, and twice as likely to die from it. That's why we're delighted that the Government has more than doubled its support for Transform and is backing our Black health equity strategy, allowing us to generate the vital evidence needed to ensure those at highest risk are diagnosed earlier, when treatment is most effective. This is only possible because of the commitment and leadership of Black communities across the country, bringing us a step closer to a world where no man dies from prostate cancer."
Part of the Government's funding will also go towards expanding the provision of focal therapy – a minimally invasive prostate cancer treatment which Lord David Cameron had. The former prime minister said Mr Murray's decision to accept the UKNSC's recommendation on population-wide screening is "too timid, too slow, and lacking the bold ambition that we so desperately wanted to see." In a post on X, Lord Cameron said: "This was an opportunity for bold, decisive, life-saving action – action that would help save the heartache of too many families losing a loved-one to this disease. That, sadly, has been missed."
