Men at higher risk of prostate cancer should be offered a test by GPs – even if they do not have any symptoms of the disease, a charity has said.
The recommendation is based on two trials by Prostate Cancer UK, which showed tests that measure prostate specific antigen (PSA) levels “reduce the number of men who die” from the disease – despite being previously deemed unreliable.
Currently, doctors offer PSA tests to men with prostate cancer symptoms, but cannot proactively offer them to high-risk men with no symptoms, such as men over 50, black men and men with a family history of the disease.
This helps to prevent patients without cancer from having further tests and treatments they do not need, such as invasive biopsies.
The NHS says PSA levels can be raised by other non-cancerous conditions, but doctors cannot tell from the test whether cancer is the cause or not.
But Dr Matthew Hobbs, director of research at Prostate Cancer UK, said current guidelines are “undoubtedly driving up late diagnosis” and causing “massive inequality across the UK”.
“Historically, the evidence that PSA testing saved lives was weak and there was strong evidence that testing caused harm,” Dr Hobbs said.
“Now, the situation has changed; we have strong evidence from two separate trials that PSA testing does reduce the number of men who die from prostate cancer.”
The trials conducted by the charity found that potential harm caused by the disease was reduced by 79% if men had a PSA test and a pre-biopsy MRI scan – compared to those who did not have an MRI.
Prostate Cancer UK is now calling for NHS guidelines to “catch up to the modern evidence”.
More than 52,000 people are diagnosed with prostate cancer every year, making it the most common cancer that affects men.
Symptoms can include trouble urinating, or an increased need to urinate, as well as blood in the urine or semen.
Clive Efford, Labour MP for Eltham and Chislehurst, was diagnosed with prostate cancer in November 2023 and said his doctors were “dismissive” when he asked for a test, despite the disease running in his family.
He said the new report “makes it clear that this reluctance from my doctors was unfounded and outdated” and that “there is no excuse for guidelines not to change”.
Various high-profile celebrities have previously spoken out about the need for regular testing.
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Sir Rod Stewart revealed in 2019 that he had been undergoing treatment for prostate cancer for three years, and said the disease was only caught early as he goes for regular check-ups.
Referrals for prostate cancer also spiked following the death of BBC presenter Bill Turnbull in 2022 and after comedian and former QI host Stephen Fry revealed his prostate cancer diagnosis in 2018.
An NHS spokesperson said it is committed to using proven and effective cancer screening techniques which can benefit patients and will work with the government to enact updates to UK screening guidance.
A Department for Health and Social Care spokesperson said it is investing £16m to find “new ways to catch prostate cancer in men as early as possible, giving them the best chance of survival”.
