Public Health supporting evidence – prostate cancer screening
Summary of recommendations
Motion Part 1: “This Council, recognising that prostate cancer can develop without obvious symptoms, will write to the Secretary of State for health and social care Wes Streeting, seeking a reassurance that a national testing scheme will be made available to men aged 40+ and those men with a family history of breast, ovarian and prostate cancer as a priority supporting Prostate cancer UK’s “Faster Fairer Better campaign”.
It is generally recognised that having an effective screening programme for prostate cancer is desirable. Wes Streeting has also confirmed in a meeting of the Parliamentary Health & Social Care Committee in April 2025 that he is supportive of prostate cancer screening.[1]
In order for screening programmes to be introduced, they need to meet certain criteria (more information below). To date, the existing evidence on prostate cancer screening does not meet these criteria, meaning that with the current technologies available screening for prostate cancer is likely to cause more harm than good.
The last evidence review for a potential UK prostate cancer screening programme was carried out in 2020, with the next one due to have been completed in 2023-4. Should Members decide to communicate with the Secretary of State on this issue, it is recommended that reassurance is sought rather on ensuring that the National Screening Committee (NSC) undertakes its next evidence review for prostate cancer screening as timely as possible.
Since the motion was initially proposed, Prostate Cancer UK is no longer promoting the ‘Faster Fairer Better’ campaign, which also had a different remit (again further details below). PCUK are now advocating for another review by the NSC of the available evidence, as PCUK believes technological advances in MRI and biopsy techniques since 2020 may tip the balance so that a screening programme will now carry more benefit than risk.
The motion suggests a targeted screening programme, i.e. to a higher risk section of the population; this is something that the NSC is able to recommend as an alternative to a whole-population screening programme if suitable. However, the current criteria for the ‘high risk’ population are: men over 50, those with black ethnicity, and those with an immediate family history of prostate cancer.
Motion Part 2: “This Council will promote an awareness campaign by publishing the risk to certain groups and to promote awareness by siting posters in male toilets and the council-owned estate such as council offices, depots, and leisure centres encouraging men over 40 and those most at risk to ask their doctor for a PSA blood test to detect more cases early in the progress of the disease.”
North Yorkshire Council does undertake prostate cancer awareness campaigns, including as part of broader men’s health initiatives such as Movember. The council also had a dedicated men’s health month in March 2025 as part of ongoing wellbeing initiatives.
Specific promotional materials that could be shared in council venues are highlighted below. However, the focus of these is to get men to better understand their risk and to be more aware of prostate cancer symptoms, rather than to direct everyone towards PSA testing which may not be the right option for everyone and is not a specific cancer test.
The Prostate Cancer UK ‘Check your risk’ tool is a quick and simple intervention that takes 30 seconds to complete and provides helpful information that is tailored to an individuals risk level (based on age, family history and ethnicity). The tool also directs if any further steps need to be taken. This could be to speak to a GP for those at high risk; however, even if individuals are at lower risk and do not need to seek further follow up the tool still provides useful information on what to look out for and what to do if your risk changes.
Prostate Cancer UK has a variety of free resources available to order via their website, including posters and small leaflets, which include links to the risk checker tool: General Information | Prostate Cancer UK Shop.
Cancer Research UK also has a prostate cancer awareness booklet available in paper copy (order for free or download) and also in mobile phone version Prostate cancer awareness – Cancer Research UK Publications.
Supporting information
What is the extent of the issue?
Around 55,100 men are diagnosed with prostate cancer in the UK each year. In men, it is the most common cancer in the UK. Prostate cancer is most common in older men. On average each year around 35% of new cases are diagnosed in men aged 75 and over.[2]
Prostate cancer is the second most common cause of cancer death in males in the UK (behind lung cancer), accounting for 14% of all cancer deaths in males in the UK. There are around 12,000 prostate cancer deaths in the UK every year. Mortality rates for prostate cancer in the UK are highest in males aged 90+. Each year three-quarters of all prostate cancer deaths (75%) in the UK are in males aged 75 and over. [3]
Prostate cancer survival has increased in the last 50 years in the UK. It is predicted around 8 in 10 (78.9%) males diagnosed with prostate cancer in the UK survive their disease for ten years or more. More than 9 in 10 (94.2%) men in the UK diagnosed with prostate cancer aged 15-44 survive their disease for ten years or more, compared with around 2 in 3 (67.5%) men diagnosed aged 75-99.[4]
Some people are likely to be at higher risk of developing prostate cancer. These include men over the age of 50, those with black ethnicity, and those with a close family history of prostate cancer.
How do screening programmes help? [5]
Cancer screening involves a test that looks for early signs of cancer in people without symptoms. It can help spot cancers at an early stage, when treatment is more likely to be successful. People with symptoms should not wait for screening and should seek medical advice as soon as possible.
There are currently national screening programmes for three types of cancer in the UK: bowel cancer, breast cancer and cervical cancer. A new targeted programme for people at high risk of lung cancer is also being rolled out. Eligible people are automatically invited for screening through their registered GP practice.
The main potential benefit of screening is saving lives from cancer:
The main risks to screening are:
Receiving a negative screening result does not prevent someone from developing the condition at a later date.
What is Prostate Specific Antigen (PSA) testing?[6]
PSA (prostate-specific antigen) is a small protein molecule which is normally found in seminal fluid (semen) released from the prostate gland during ejaculation. A very small amount is also released into the bloodstream. With age, the prostate slowly enlarges and produces more PSA, so blood levels of PSA gradually increase. The larger the prostate, the higher the blood test PSA.
The PSA blood test is not a specific test for prostate cancer. Raised levels may also be caused by inflammation, infection or benign enlargement of the prostate, ejaculation, vigorous exercise within 48 hours of the test, recent surgery, other procedures to the prostate, urethra or bladder, or problems with urination.
PSA levels can fluctuate, so the test may have to be repeated to check if levels are consistently raised.
There is no "normal" level of PSA, but there are medical guidelines to identify men at risk of prostate cancer, based on their PSA result.
Why is there currently no screening programme for prostate cancer?[7]
In the UK, the National Screening Committee (NSC) advises ministers and the NHS regarding all aspects of screening and supports implementation of screening programmes.
The NSC has set criteria for appraising the viability, effectiveness and appropriateness of potential population-wide and targeted screening programmes. These criteria relate to the condition being reviewed, the proposed screening test, the intervention should screening tests be positive, and the feasibility of the screening programme and its implementation.
Based on the last UK NSC review that occurred in November 2020, screening is not currently recommended for prostate cancer. The reasons given by NSC included:
- The PSA test is not accurate enough to detect prostate cancer that needs treatment. It can falsely find men who do not have prostate cancer. It can also miss some cancers. This means that many men might have to undergo unnecessary and often unpleasant tests and/or unnecessary treatment.
- It is still unclear if other tests such as an MRI scan, with or without PSA, are accurate enough. Research is also currently looking at whether a method for predicting prostate cancer risk using a combination of a blood test and other information about a man could be more accurate. But more studies are necessary to confirm the early results.
- At present, there is no single treatment that is definitely better for patients with early-stage prostate cancer, as treatments’ effectiveness needs to be weighed up against their side effects.
- It is unclear how PSA screening impacts deaths due to prostate cancer.
- A PSA-based screening programme could harm men as some of them would be diagnosed with a cancer that would not have caused them problems during their life. This would lead to additional tests and treatments which can also have harmful side effects.
The UK NSC reviews conditions every 3 years to determine whether it can recommend a screening programme. The last review for prostate cancer was done in 2020, with the NSC website listing 2023-4 as the timescale for the next review.
What is the Prostate Cancer UK position?
At the time of the initial motion to Full Council on the 16th July 2025, Prostate Cancer UK were promoting their ‘Faster, Fairer, Better’ campaign, which was targeted towards the first year of the new Government.[8] The campaign was not asking for a national screening programme (recognising that with the current technologies available, population-level screening for prostate cancer is not recommended on the balance of benefits vs wider harms). Instead, the campaign focused on three main drivers:
- FASTER – pushing for quality improvements to existing MRI scans, plus an increase in MRI capacity, to speed up diagnosis rates
- FAIRER – pushing for updates to NHS guidance to recognise that black men, men with a family history of prostate cancer, and men from deprived areas are disproportionately impacted, to enable GPs to proactively have conversations with high-risk men rather than only men with symptoms
- BETTER – building new evidence through research on screening pathways
Since the Full Council meeting on 16th July 2025, the Prostate Cancer UK position has moved on to focus on advocating for the NSC to complete a further review of the evidence around prostate cancer screening, on the basis that they feel there is now enough improvement in diagnostic techniques (MRI scans and biopsies) that the benefits of a screening programme would outweigh the harms for those who are at highest risk of the disease. The PCUK website suggests that NSC will undertake a further evidence review on prostate cancer screening programme later this year (although no consultation is currently open on the NSC website).[9]
PCUK continue to fund research into prostate cancer, including the ongoing TRANSFORM trial, in order to further develop the gaps in the evidence base on prostate cancer screening.[10]
What is already being done in NYC to raise awareness of prostate cancer?
Information about prostate cancer awareness is promoted as part of NYC wellbeing messaging. This is often linked into men’s health initiatives such as Movember, with information shared last year covering prostate cancer awareness and symptoms, the Prostate Cancer UK risk checker, and various links for people to find out further information.
Similarly in March 2025 as part of a month-long focus on men’s health, Wellbeing Wednesday focused on men’s cancer risks including prostate cancer. This article shared additional information on Cancer Champion awareness sessions as well as signposting to the Health Assured employee service and further links to sources of health information.
There is ongoing regular promotion of Cancer Champion sessions delivered by the Humber and North Yorkshire Cancer Alliance. These are free cancer awareness raising sessions lasting 90 minutes that anyone can attend, with virtual and face to face options available (more details available here - Cancer Champions – Humber and North Yorkshire Cancer Alliance).
Members may be interested in becoming Cancer Champions, or promoting these sessions through their own networks too.
The Department of Health & Social Care is currently developing a Men’s Health Strategy for England.[11] Consultation on the strategy in recent months suggests that tackling men’s cancer rates will be a core component of this, aligning with the national cancer plan for England to set out how to improve men’s experiences and cancer outcomes. Once published, NYC will look to see how to align relevant work to the Strategy. In the meantime, the public health team continues to work with partner organisations including Menfulness and the Mayoral Combined Authority on men’s health initiatives.