March 15, 2026

expert reaction to conference abstract comparing prostate cancer and breast cancer screening programmes, being presented at the European Association of Urology Congress

Expert reaction to conference abstract comparing prostate cancer and breast cancer screening programmes, being presented at the European Association of Urology Congress

A conference abstract that was presented at the European Association of Urology Congress comparing prostate cancer and breast cancer screening programmes

Prof Sam Hare, CEO of the HLH Imaging Group, Past National Specialty Adviser Imaging (NHS England), said:

“The PROBASE trial lends further weight behind a risk-stratified, PSA and MRI based approach to screening for prostate cancer, in a study population that is similar to the UK.  The cancer detection rates in the trial are comparable to the breast cancer screening programme, and although the false positive rate is high, it is hoped that this could be further reduced with the implementation of Artificial Intelligence (AI) and ensuring radiologists involved in such a screening programme are appropriately credentialed, with a robust quality assurance (QA) process and some ‘double reading’ as part of ongoing QA.  

“It will be very interesting to see how these results will be considered by the National Screening Committee when they issue their guidance for prostate cancer screening in the UK. “

Dr Alastair Lamb, Clinical Reader, Barts Cancer Institute, & Prostate Surgeon, Guys Hospital, said:

“Breast cancer screening is an odd benchmark given that not many experts would claim breast-screening as a success. Breast cancer is a symptomatic disease, so it is well suited to a screening programme. But, just like prostate cancer, most breast cancer is indolent. Giving people a diagnosis of cancer can deliver psychological harms and may alter behaviour (e.g. choosing treatment when you don’t need it). The big difference is that breast cancer treatment itself, (e.g. surgery) rarely causes harm – although it certainly can cause aesthetic/psychological impact – whereas pretty much all prostate cancer treatment can cause many functional harms e.g. bladder/bowel/erectile dysfunction. Nonetheless, the comparisons presented in this trial are useful given the wide public acceptance of mammography as a screening tool.

“Overall, while turnout was high, the PROBASE team have shown that prostate cancer screening delivers too many false positives.

“The debate continues around what constitutes a life-altering diagnosis, and so it is hard to concur with the authors conclusion that their study supports implementation of prostate cancer screening”

Simon Grieveson, Assistant Director of Research at Prostate Cancer UK, said:

“Prostate cancer is now the UK’s most common cancer, and in the absence of a screening programme too many men are dying from a disease that can be cured if diagnosed early.

“Breast cancer screening has been established for decades and without a screening programme for prostate cancer it is difficult to make direct comparisons. Whilst this study has revealed some interesting correlations, unfortunately, there still is not enough evidence here to prove that introducing screening will save the lives of men with aggressive cancer while also protecting men with slow-growing cancer from potentially harmful treatments they don’t even need. These results suggest that screening for prostate cancer would cause higher rates of false positive test results and detection of low-grade cancers which are unlikely to cause any harm. These findings also do not take into consideration a number of other important factors that would make prostate cancer screening feasible.

“To definitively demonstrate the effectiveness of population-wide screening we still need gold-standard evidence from large-scale trials that leave no questions unanswered — and that’s exactly what Prostate Cancer UK’s once-in-a-generation £42m TRANSFORM trial is aiming to deliver.”

Dr Lennard Lee, Associate Professor, University of Oxford, said:

“Other nations, like Germany are generating important evidence on modern prostate cancer screening in a systematic fashion. This study suggests that risk-adapted screening using PSA followed by MRI can detect clinically significant cancers with performance that resemble those seen in established breast cancer screening programmes. The UK has rejected the use of prostate cancer screening with PSA since an original decision in 1997.

“One historic concern with PSA screening has been the detection of low-risk cancers. Today this is increasingly managed through MRI triage and active surveillance, which helps reduce unnecessary treatment and risks.

“The limitation is that these results are currently presented as an abstract, so the full paper will be important to examine in detail.

“As screening technologies evolve, there is a strong case for piloting modern prostate cancer screening programmes in real healthcare systems and assessing outcomes regionally, rather than waiting decades for randomised trials that may not fully represent how screening works in practice, and not give results for decades.”

* The abstract ‘Risk-adapted prostate cancer screening achieves mammography-like benefits – Results from the PROBASE trial’ by Carlsson S et al. was presented at the European Association of Urology Congress 

Declared interests

Prof Sam Hare: “No conflicts of interest directly relevant to this work. I am a past National Specialty Adviser to NHS England for Imaging. I am CEO and co-founder of the HLH Imaging Group Limited.”

Dr Alastair Lamb: “ADL is funded Cancer Research UK (RCCASF-Nov24/100001) and UCARE (1120887). He has also received funding from NIHR HTA (NIHR131233) as co-CI of the TRANSLATE prostate biopsy trial, and the John Black Charitable Foundation as prostate module lead of the QUANTUM Biobank. He has received educational support from Intuitive Surgical, BXT Accelyon, GlaxoSmithKline, Astellas, Lilly, Astrazenaca and Ipsen. He is a stipendiary BJUI Section Editor for prostate cancer and has received honoraria for reviewing from European Urology and Lancet Oncology. He has also received consulting fees from AlphaSights. His private practice focusses entirely on treating men with prostate cancer and he acknowledges that any academic article written or talk delivered may increase visibility for potential future patients. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the talk/manuscript.”

Dr Lennard Lee: “Dr Lennard Lee is an Associate Professor at the University of Oxford and a medical oncologist. Comments provided in a personal academic capacity.”

For all other experts, no response to our request for DOIs was received.