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Scientists comment on estimates from Macmillan and reported exclusively by PA on the number of men living with prostate cancer in the UK.
Dr Matthew Hobbs, Director of Research at Prostate Cancer UK, said:
“These figures from Macmillan Cancer Support highlight the growing number of men living with prostate cancer across the UK, which is being driven by a combination of different factors.
“We know that greater awareness of the disease has contributed to the recent surge in cases, as has the ageing population in the UK, with prostate cancer seen more commonly in older men.
“At the same time, research has helped drive major improvements in treatment over recent years, meaning more men are living longer after a prostate cancer diagnosis. That is positive progress, but it also means the number of men living with the disease will continue to grow.
“These findings are a reminder that one in eight men will get prostate cancer and men over 50, Black men over 45, and men with a family history of prostate cancer are all at higher risk of getting the disease. It’s vital that men can access clear information about their risk and the potential benefits and limitations of PSA testing, so they can make an informed choice about what’s right for them.
“With more men than ever living with prostate cancer, it’s also essential that they have access to the treatment, support and clinical care they need to live well.”
Prof Prabhakar Rajan, Professor of Urology and Robotic Surgery, Barts Cancer Institute, Queen Mary University of London (QMUL), said:
“It’s important to be careful about what the increase in the number of men ‘living with’ prostate cancer actually tells us. It doesn’t necessarily mean that prostate cancer itself has become 20% more common. More men may be being diagnosed because of greater awareness and increased use of PSA testing, but there may be other reasons for the rise.
“Men are also living longer with prostate cancer than they did in the past, including those with slow-growing cancers that are monitored rather than immediately treated. There are also men whose cancer has spread and cannot be cured, but can be controlled with advances in treatment for many years.
“So, the rise is likely to reflect a mixture of factors. To understand what is really behind the increase, we need to look at whether the number of men developing prostate cancer each year is rising, alongside changes in PSA testing, diagnosis and survival.”
Dr Adam Brentnall, Reader in Biostatistics, Queen Mary University of London (QMUL), said:
“There is limited published information on trends in PSA testing over the past five years. However, data from NHS England’s Rapid Cancer Registration Data dashboard strongly suggest that the recent rise in prostate cancer diagnoses is largely being driven by increased PSA testing among men who do not have symptoms of prostate cancer [1].
“The number of men diagnosed with prostate cancer fell substantially during the Covid-19 pandemic in 2020. Diagnosis rates returned to pre-pandemic levels by 2022 and have continued to rise since then. Consistent with recent findings reported by Macmillan Cancer Support, the data show that prostate cancer diagnoses are now around 20% higher than in 2019, equating to roughly 1,000 additional diagnoses every month in England.
“Much of this increase has occurred among men aged 60 to 79 years and has been driven by a rise in the detection of early-stage disease. In particular, the number of men diagnosed with Stage 1 prostate cancer has reached unprecedented levels, rising from around 1,000 diagnoses per month in 2019 to almost 2,000 per month in 2026.
“Taken together, these data strongly suggest that PSA testing in asymptomatic men has increased substantially and is likely to be at its highest level ever in England.
“While earlier detection of prostate cancer can be beneficial, the increase in Stage 1 diagnoses is not automatically good news. PSA testing has a complex balance of harms and benefits [2], and the balance depends heavily on a man’s age at the time of testing and diagnosis [3].”
“For men in their 50s and early 60s, earlier detection is more likely to prevent the development of advanced cancer and reduce the risk of dying from prostate cancer. In these age groups, the risk of diagnosing cancers that would never have caused problems during a man’s lifetime, known as overdiagnosis, is also low.
“However, evidence from randomised controlled trials suggests that routine PSA testing provides little or no benefit for men over the age of 70, while substantially increasing the risk of overdiagnosis. For these men, detecting a cancer that would never have become clinically important does not improve life expectancy and might lead to unnecessary treatment and reduced quality of life.
“In this context it is worth noting some recently published research I was involved with [3]. This suggested that introducing an organised, risk-based English prostate cancer screening programme, while reducing opportunistic PSA testing, could improve outcomes. Such an approach could increase the benefits of PSA testing while reducing unnecessary PSA tests and the harms and costs associated with overdiagnosis.”
[1] https://nhsd-ndrs.shinyapps.io/rcrd/
[3] https://onlinelibrary.wiley.com/doi/10.1002/ijc.70698
Mr Ben Lamb, Consultant Urological and Robotic Surgeon, Barts Health and UCLH NHS Trusts, and Clinical Senior Lecturer, Barts Cancer Institute, Queen Mary University of London (QMUL), said:
“The estimated increase in men living with or after prostate cancer in the UK—from around 500,000 in 2020 to approximately 600,000 now—probably reflects several overlapping trends rather than a single cause.
“First, more men are being diagnosed. Prostate cancer diagnoses have risen substantially in recent years: UK data show more than 64,000 diagnoses in 2022, compared with just under 52,000 in 2021. Greater public awareness, increased PSA testing among men at risk, wider use of pre-biopsy MRI, and more accurate biopsy pathways are likely to be identifying cancers that might previously have remained undetected for longer.[1]
“Second, men are often being diagnosed earlier and are therefore living for more years with the label of prostate cancer. This is particularly important for men with localised or low-risk disease managed with active surveillance, as well as those treated successfully with surgery or radiotherapy. Prevalence counts everyone living after a diagnosis—not only those with active or advanced cancer—so improved detection and long post-diagnosis survival will increase the total even if the annual death rate changes little.
“Third, survival for men with advanced disease has improved. More effective systemic treatment—including intensified androgen-deprivation approaches, abiraterone, enzalutamide, apalutamide and darolutamide—has extended disease control and, in appropriate settings, survival. NHS England has also expanded access to abiraterone in earlier high-risk disease; trial data cited by NHS England showed six-year survival of 86% with abiraterone compared with 77% with standard treatment. Lutetium-177 PSMA radioligand therapy is another important development for selected men with metastatic castration-resistant prostate cancer, although its contribution to overall UK prevalence is likely to be smaller at present because it is used in a relatively narrow, advanced-disease population.[2]
“A genuine rise in the underlying occurrence of prostate cancer is also possible. The UK population is ageing, and age is the dominant risk factor for prostate cancer. However, the recent growth in the number of men living with the disease is more likely to be driven principally by increased and earlier diagnosis combined with better survival, rather than by a large sudden increase in age-specific biological risk alone.
“Why the distinction matters: For policy, this is not simply a story of “more cancer.” It is a story of a growing population of men who may live for many years with the consequences of diagnosis and treatment.
Services need to plan not only for diagnostics, surgery, radiotherapy and systemic treatment, but also for:
• Long-term PSA surveillance and rapid access back into specialist care.
• Management of urinary, sexual, bowel, hormonal, metabolic and bone-health consequences.
• Psychological support, including anxiety around surveillance, recurrence and metastatic disease.
• Rehabilitation, partner and family support, work and financial advice.
• Equitable access to early diagnosis and high-quality treatment, particularly for Black men and men in underserved communities.
“The policy objective should therefore be to maximise both quantity and quality of life: detecting clinically significant disease early enough to cure it where possible, avoiding unnecessary harm from overdiagnosis and overtreatment, and providing durable, person-centred support for the large and growing number of men living with or beyond prostate cancer.”
1) https://prostatecanceruk.org/about-us/news-and-views/2026/01/prostate-most-common-cancer
Figures derived from the following sources:
– Macmillan Cancer Support. Cancer prevalence. Accessed August 2026
– NHS England
– Public Health Scotland
– Public Health Wales
– Northern Ireland Cancer Registry, Queen’s University Belfast
Declared interests
Prof Prabhakar Rajan: “Prabhakar Rajan is a director and founder of healthXY Ltd, has received reimbursement for consultancy and advisory boards from Antev Ltd and Medtronic Ltd, speaker fees from Janssen-Cilag Ltd (Johnson & Johnson), and educational support from Angiodynamics UK Ltd, EDAP TMS S.A., HC 21 Healthcare Ltd, Medtronic Ltd, and Janssen-Cilag Ltd (Johnson & Johnson). “
Dr Adam Brentnall: “I am a member of the UK National Screening Committee Research and Methodology Group, a co-investigator on the TRANSFORM prostate cancer screening trial and co-PI on the AVIDITY prostate cancer imaging study. Other research includes work on prostate cancer detection using artificial intelligence. I receive or have received research funding from Prostate Cancer UK, Cancer Research UK, the National Institute for Health and Care Research (NIHR), Breast Cancer Now and Barts Charity. Some further potential conflicts are listed on this page: https://www.gov.uk/government/publications/uk-national-screening-committee-register-of-interests/research-and-methodology-group”
Mr Ben Lamb: “Benjamin W. Lamb has received funding from Cancer Alliances and NHS England for training MDTs in assessment and quality-improvement methods; honoraria for public speaking from Parsek, AstraZeneca and Astellas; and consultancy fees from Digital Surgery Ltd and MDOUTLOOK. He is a co-founder of healthXY. Any interests relevant to the subject of this work/presentation are declared and managed in accordance with the hosting organisation’s policy.”
For all other experts, no reply to our request for DOIs was received.