NHS advisers poised to Reject Widespread Prostate Cancer Screening
London, UK – A committee advising teh National Health Service (NHS) is expected to reject calls for a national prostate cancer screening program, citing a lack of conclusive evidence that benefits outweigh potential harms. The decision, anticipated shortly, comes despite pressure from patient advocacy groups and the government to implement routine screening.
the UK National Screening Committee is currently reviewing the evidence, with experts warning that rushing into a national program could lead to unnecessary anxiety and treatment for hundreds of thousands of men.
“I would be surprised if they saeid anything very different,” said researcher Ahmed, who is leading a major trial to evaluate different screening methods and their impact on mortality and morbidity. “It would be the right decision if they decide not to go for screening.” His trial could take over a decade to yield definitive results. “If we rush this we could end up harming hundreds of thousands of men unnecessarily,” he warned. “That would be very wrong – it is worth waiting for that bigger study in order to ensure that we do right by men.”
The debate centers on the PSA (prostate-specific antigen) test, which can detect early signs of prostate cancer but also produces false positives, leading to invasive biopsies and possibly unnecessary treatment for slow-growing cancers that may never pose a threat.
Ahmed acknowledged the distress of men diagnosed late, stating, “I appreciate there are individuals who feel they were diagnosed late and I have no answer to them when they say they could have been diagnosed through screening. I have to keep in mind all those dozens or hundreds of men who, if they had been screened, would have been harmed.”
While widespread screening is unlikely,the committee is considering targeted screening for black men and those with a family history of prostate cancer,both groups at higher risk. However, it is believed insufficient evidence exists to support this approach, alongside logistical challenges in identifying eligible individuals within the NHS. Screening for men with BRCA gene mutations is seen as a more probable outcome.
Chiara De Biase of Prostate Cancer UK emphasized the need for evidence-based decisions. “It is indeed incumbent on us to only support a screening where we certainly know we will reduce harm, not just finding prostate cancers. It’s a really difficult head-over-heart conversation … we need the public to trust the science on this.”
De Biase indicated there is evidence supporting screening for Black men, but acknowledged potential concerns about accusations of experimentation or implementing a screening program perceived as driven by “woke” ideology. She stated the institution would abide by the committee’s findings, even if disappointing to the Black community, if clinical and cost-effectiveness cannot be demonstrated.
Prostate Cancer UK is also advocating for a change in NHS guidelines to allow GPs to proactively offer PSA tests to men at highest risk,rather than waiting for them to request it. “We will never tell men to have a PSA test,” De Biase said, “[But] just expecting men to come in and ask for it isn’t informed choice.”
A Department of Health spokesman affirmed the government’s desire for screening, but stressed the importance of an “evidence-led” decision. “This government has been clear it would like to see screening in place, but the decision must be evidence-led. The independent UK National Screening Committee is looking at this as a priority and we will consider its advice.”
