May 28, 2026

expert reaction to final recommendation from the UK National Screening Committee for prostate cancer screening

Scientists comment on a final recommendation for a national screening programme for prostate cancer from the UK National Screening Committee (UKNSC).

Professor Frank Chinegwundoh, consultant urologist at Barts Health, said: 

“I am deeply disappointed with the recommendation of the National Screening Committee, particularly in relation to black men who have double the risk of getting prostate cancer. I think men can decide for themselves whether they wish to be screened or not and whether the small risk of potential harm outweighs the benefits. Men should be given the opportunity to be screened rather than the current ad hoc arrangements which disadvantage large segments of the population.”

Professor Prabhakar Rajan, Professor of Urology and Robotic Surgery, Queen Mary University of London, said:

“The UK National Screening Committee’s decision not to recommend population-wide prostate cancer screening will be disappointing for many men affected by prostate cancer, their families, and communities who experience a disproportionate burden of disease.

“While targeted screening for higher-risk groups is a pragmatic, evidence-based approach, it is essential that implementation does not inadvertently widen inequalities or discourage healthcare engagement among those who fall outside the eligibility criteria. Clear communication, equitable access to informed decision-making and testing, and continued investment in awareness will be critical.

Importantly, the committee has recognised that significant uncertainties remain.

“Ongoing UK studies such as IMProVE and TRANSFORM are likely to play a vital role in identifying safer and more effective screening strategies that maximise early detection while minimising the harms of overdiagnosis and overtreatment.”

Professor Ros Eeles, Professor of Oncogenetics at The Institute of Cancer Research, London, said:

“We are pleased to see that individuals with a BRCA2 pathogenic alteration will now be offered prostate cancer screening, however the IMPACT study which was an international targeted screening study, led by our group at The Institute of Cancer Research, showed that such screening should  be offered annually from 40 to 69 years and not 2 yearly as cancers were detected in each screening year. Furthermore, stopping at 61 years as stated in these recommendations rather than 69 years as in the IMPACT study,  misses 42% of prostate cancers in those with a BRCA2 pathogenic alteration. We hope that there will be an early review of these recommendations in other high risk groups also as we have shown in IMPACT that BRCA1 alterations are associated with higher risk disease.”  

Dr Alastair Lamb, Clinical Reader, Barts Cancer Institute, St Bartholomew’s Hospital, said:

“These are broadly consistent with the NSC’s draft recommendations in November 2025 and therefore not controversial. In my opinion, the committee has been canny in opening the door to a targeted PSA screening programme for an inherited gene variant (only BRCA2,  BRCA1 not included this time), arguably the only group with strong evidence pointing to early development of aggressive prostate cancer. This is a very small number of men, around 10-20,000, therefore, the impact of this programme will be minimal (except for those with the variant). However, the significance is huge as it shows a willingness to consider screening if the evidence for reliable harm reduction is present. It is therefore also significant that the formal recommendations specifically highlights the need to work closely with UK researchers, particularly those conducting the TRANSFORM trial, which will provide the much-needed evidence we so desperately need to work out who and how to screen for prostate cancer.”

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

“We are deeply disappointed with this final recommendation from the UK NSC which scales back even further from their initial findings. We recognise there is still not enough evidence to support screening for all men at risk, however Prostate Cancer UK is rigorously scrutinising the evidence behind today’s decision and will challenge it where we disagree, as, if accepted by the Government, the programme may only screen a few thousand men each year.

“We know that more must be done to save the lives of men with prostate cancer, and we have to start with men at highest risk of the disease including men with family history and Black men. Prostate Cancer UK will continue to work tirelessly to provide the robust evidence needed to show the best way to screen men to save more lives while reducing harms from overdiagnosis and over treatment, and our £42million TRANSFORM trial already underway is perfectly positioned to achieve this. Early results from the trial could provide the evidence needed to tip the balance in favour of screening in as little as two years, and will close the crucial evidence gaps for men at highest risk like Black men, and the wider population.”

Dr Adam Brentnall, Reader in Biostatistics, Queen Mary University of London (QMUL), said:

“The UK NSC has advised against population-based PSA screening, in part because of uncertainty in results from a complex health-economic model. While I have not seen the model used to make the final recommendation, having seen the model used to make the draft recommendation, there was an urgent need for further modelling which I hope was addressed – because that model lacked face validity with the wider body of evidence. Limitations of the model used to make the draft recommendation, include substantial miscalibration of UK prostate cancer incidence by age, and prostate cancer mortality by age. The model also lacked face validity for overdiagnosis, and as a consequence, associated harms from screening. For example, the model projected overdiagnosis (proportion of men with prostate cancer detected at screening who would not otherwise be diagnosed in their lifetime) from a one-off screen to be 28% for a 50 years old, increasing to 82% for a 70 years old; and an associated infographic gave a headline figure of 71% (20/28) for screening men aged 50–60 years. Based on a recent analysis using long-term data from the CAP randomised trial, these are substantial overestimates (https://doi.org/10.1002/ijc.70492). A more fundamental limitation of the model used by UK NSC for the draft recommendation, is that it evaluated a policy of organised screening on top of a policy that enables opportunistic testing, which few would advocate irrespective of modelling. For example, that analysis did not consider that an organised programme could reduce overdiagnosis and associated harms compared with the current “Prostate Cancer Risk Management Program” that enables opportunistic PSA testing. This might be achieved by ending the availability of PSA testing through primary care for older men without new or worsening symptoms of potential prostate cancer. Therefore, in my view, the model needed further work, which I hope was addressed before making this final recommendation, for it to be sufficiently considered reliable to project the impact of organised-screening regimens relative to the current policy. Further work on the model would help to reduce uncertainty in assessment of the trade-off between benefits and harms from risk-based population screening for prostate cancer – and support future UK NSC decision making on prostate cancer screening.”

Prof Hashim Ahmed, Professor of Urology, Imperial College London, said:

“The NSC final recommendation following the period of consultation reinforces what the data has consistently shown – that currently the harms unfortunately outweigh the benefits of population level screening for most high-risk groups and the population as a whole. 

“The need for robust data is ever more pressing across all groups of men. The NIHR and Prostate Cancer UK funded TRANSFORM study will be critical to fill the evidence gaps that the NSC have identified. TRANSFORM will hopefully show that we can reduce the harms of over-diagnosis, over-treatment and treatment-related side-effects, but also address the harms of late diagnosis that leads to thousands of men suffering the ill effects of cancer that has spread and thousands still dying of the disease every year.“

Declared interests

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.”

Simon Grieveson: “Prostate Cancer UK (PCUK) are the major funder of the £42 million TRANSFORM trial which has been backed by the Government for £16 million, and Simon is employed by Prostate Cancer UK.”

Dr Adam Brentnall: “I am a member of the UK National Screening Committee Research and Methodology Group, and a co-investigator on the TRANSFORM trial of prostate cancer screening. 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”

Prof Hashim Ahmed: HU Ahmed also receives infrastructure support from the NIHR Imperial Biomedical Research Centre and NIHR/CRUK Imperial Experimental Cancer Medicine Centre; the Wellcome Trust, the UK NIHR, the UK Medical Research Council, Cancer Research UK, Prostate Cancer UK, The Urology Foundation, the British Medical Association Foundation, Imperial Health Charity. He was awarded NIHR Senior Investigator status in 2023 He has previously received travel grants and paid proctorships and trial grants from Sonablate; was a paid consultant for Sophiris Biocorp; sponsored conference attendance by Angiodynamics; medical advisory board for Janssen previously in the last 3 years; is a proctor for Rezum treatment and cryotherapy for Boston Scientific and a paid proctor for HIFU by Sonablate. He has received paid speaker honorariums from Varian Medical. He is the Chief Investigator for the IP7-PACIFIC and TRANSFORM trials.

Professor Ros Eeles: on the steering committee for the TRANSFORM trial.

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

This Roundup was accompanied by an SMC Briefing.