Prominent public figures, including former Prime Minister Rishi Sunak, Olympic cyclist Sir Chris Hoy, and film director Sir Steve McQueen, have urged the government to introduce targeted prostate cancer screening for men at higher risk of developing the disease.
Currently, the NHS does not provide routine testing for prostate cancer or related conditions such as an enlarged prostate. However, men over 50 who wish to be screened can request a prostate-specific antigen (PSA) test from their GP, regardless of whether they have symptoms.
Higher Risk in Black Men and Those With Family History
Prostate Cancer Research, a charity supported by Sunak, has called for doctors to take a more proactive approach by initiating discussions about prostate cancer risk—particularly with Black men and those with a family history of the condition. Research shows that Black men are twice as likely to develop prostate cancer compared to white men, and those with familial links also face significantly elevated risk.
Sunak told the BBC that expanding and targeting screening could “save countless lives.” Sir Chris Hoy, who has been diagnosed with stage 4 prostate cancer, echoed this sentiment, calling for earlier detection measures.
However, experts caution that the issue is far from straightforward.
Experts Warn Against Overdiagnosis and Overtreatment
Professor Hashim Ahmed, Chair of Urology at Imperial College London, told the BBC that widespread screening could lead to unnecessary interventions.
“We can often find disease that doesn’t need to be treated, and we end up causing harm,” he said. “At the moment, that harm-to-benefit equation isn’t quite right.”
GP and medical adviser Dr Suzanne Wylie agrees the issue is complex.
“As a GP, I can appreciate the interest in lowering the age for prostate screenings, but it’s more complicated than it might seem,” she told HuffPost UK.
She supports earlier discussions about PSA testing for those at higher risk, such as men of Black African or Caribbean heritage or those with a strong family history of prostate cancer. The NHS currently invites men over 50—or 45 for higher-risk groups—to discuss PSA testing with their GP, where the benefits are more likely to outweigh potential harms.
Inequalities in Access to Care
A 2022 study found that Black men experience longer delays between diagnosis and treatment and have less access to PSA screening compared to other groups, highlighting ongoing health inequalities.
Even so, Dr Wylie cautioned against lowering the screening age for all men, saying it could lead to overdiagnosis and overtreatment.
“Prostate cancer is often slow-growing, and many men may never experience symptoms or have their life shortened by it,” she said.
“Screening with the PSA test can detect cancer early, but it also carries significant risks—such as unnecessary biopsies, anxiety, incontinence, or sexual dysfunction.”
Balancing Benefits and Harms
Some prostate cancers grow so slowly that “active surveillance”—monitoring rather than immediate treatment—may be appropriate.
According to Prostate Cancer UK, an estimated 5,000 men a year receive unnecessary treatment for prostate cancer that could safely be managed through observation.
The charity argues this is a reason to improve, not avoid, screening, suggesting that better diagnostic tools such as MRI scans could make early detection more accurate and reduce unnecessary interventions.
Dr Wylie emphasized that any move toward population-wide screening must be backed by solid evidence.
“Ultimately, lowering the age for universal screening would require robust proof that benefits clearly outweigh harms, alongside careful resource planning and patient education,” she said.
What Men Should Know
The NHS advises men to speak with their GP if they are over 50, Black, or have a family history of prostate cancer, particularly if they are concerned about their risk.
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