How Do We Fight the UK’s Most Common Cancer?
By Sean Colligan
A recent report by the UK National Screening Committee (UK NSC) has put prostate cancer back into the media spotlight, following public diagnoses of prominent figures such as David Cameron and Joe Biden. The NSC has recommended against whole population screening for the disease which claimed just under 400,000 lives in 2022 [1], stating that such an initiative would be “likely to cause more harm than good” [2]. The announcement is certainly controversial—Olympic cycling champion Chris Hoy, who suffers from a terminal form of prostate cancer, as well as Stephen Fry and Rishi Sunak, both long-time campaigners on the issue, have gave fervent criticism of the NSC’s report.
The main problem arises in the use of the PSA test. It measures the amount of prostate specific antigen (PSA) in the blood, with raised levels a common indicator of cancer. The NSC’s concerns revolve around the accuracy of the test and its potential for overdiagnosis and false positives, leading to overtreatment and possible harm. Targeted screening of Black men and those with a relevant family history of the disease were two more proposals rejected by the NCS for similar reasons. PSA levels themselves aren’t a definite indicator of prostate cancer—some men with aggressive cancer can still present with normal results, while those with higher levels may be completely healthy. In the NSC’s own words, “a more accurate test than PSA is needed” [3].
But what are the alternatives for mass screening? Currently, more advanced tests such as the EpiSwitch blood test [4]—shown to improve the predictive accuracy of a standard test from 55% to 94%—only exist on the US market and have not been cleared for use on the NHS. In lieu of trying to detect the disease in all men, the NCS recommends a strategy of regularly testing older men with confirmed BRCA1 and BRCA2 mutations, genetic variants which increase the risks of certain cancers. All of this is provisional pending a final decision in March from Health Secretary Wes Streeting. He plans to “change the NHS so it diagnoses earlier and treats faster”, but that those plans will have to be “balanced against the harms that wider screening could cause” [5].
This all presents a massive problem for the future. With annual deaths from the disease predicted to increase by 85% and cases set to double by 2040 [6], something clearly must be done; yet without any advances in technology it appears that there is very little hope for sufferers and their families. There is no clear right answer in the controversy surrounding mass testing. Experts are right to advocate against introducing PSA tests for all older men upon looking at the facts presented, but those with the disease are also perfectly valid in wanting something more to be done. As someone who has lost a close family member to prostate cancer, and is therefore potentially susceptible to it in later life through family history, I am disappointed by the NCS’ announcement. While those aforementioned statistics will only naturally vanish—and probably have by publication—from the news cycle within days, they will stay with those suffering from the disease, their families, and those bereaved by it.
More investment and research must go towards better testing and treatment. The NCS has pledged its support to the newly introduced TRANSFORM trial, which aims to “develop more accurate testing strategies” to diagnose prostate cancer more efficiently [7]. While developed in consultation with the UK Government and the NHS, it is clear the government should act more robustly by starting the clinical introduction of these new and improved blood tests such as the EpiSwitch to then carry out mass screening of at-risk groups and the general population. The sad reality is that this is only one of many public health concerns the NHS currently has to deal with, and can only be tackled when the Health Service is granted increased funding from Westminster and Stormont. This Labour government has promised a renewal in our public services—the NHS being Clement Attlee and Nye Bevan’s most famous creation—and this March time it will become clear whether or not Wes Streeting and Keir Starmer intend on honouring that commitment.
References
- “Prostate Cancer Statistics.” World Cancer Research Fund. https://www.wcrf.org/preventing-cancer/cancer-statistics/prostate-cancer-statistics/
- “Screening for prostate cancer.” UK National Screening Committee. 28 November 2025. https://view-health-screening-recommendations.service.gov.uk/prostate-cancer/
- “Screening for prostate cancer.” UK National Screening Committee. 28 November 2025. https://view-health-screening-recommendations.service.gov.uk/prostate-cancer/
- Clarke, Hannah. “EpiSwitch Prostate Screening blood test launches on US market.” Urology Times. https://www.urologytimes.com/view/episwitch-prostate-screening-blood-test-launches-on-us-market
- “Streeting ‘examining evidence’ after experts advise against prostate cancer screening for most men.” BBC News. https://www.bbc.co.uk/news/live/clykgr941ddt
- Thomas, Rebecca. “Prostate cancer cases to double by 2040, new research suggests.” The Independent. https://www.independent.co.uk/news/health/prostate-cancer-cases-deaths-rise-b2523524.html
- “Screening for prostate cancer.” UK National Screening Committee. 28 November 2025. https://view-health-screening-recommendations.service.gov.uk/prostate-cancer/
