Introducing a prostate cancer screening programme for high-risk men would help to reduce ‘entrenched’ health inequalities among Black men and those in areas of high deprivation for a ‘modest’ cost to the NHS, a new report has said.
The report by Prostate Cancer Research, called Prostate Cancer Screening: The impact on the NHS, looked at the impact of a screening programme on NHS finances and workforce.
It found that the programme would cost £18 per patient, or £25m annually, which it said was around 0.01% of the NHS budget. This is ‘broadly in line’ with existing national cancer screening programmes, such as breast cancer screening which is estimated at £22 per patient. Cervical cancer and bowel cancer screening are both £12 per patient.
A programme would also require an uplift in NHS workforce by between 0.01%-0.4% full-time equivalent roles.
However, the programme would ‘reduce entrenched inequalities for Black men, those with a family history of prostate cancer and those in areas with high levels of deprivation’.
It added that adopting innovations such as reflex blood tests, AI-enabled MRI, polygenic risk scores, digital pathology would reduce pressures on services and help ‘pave the way’ for future whole population screening.
The report called on the National Screening Committee (NSC) to recommend a national screening programme for high-risk men aged 45-69, and said the Department of Health and Social Care (DHSC) should ensure funding and workforce plans enable this.
It highlighted that prostate cancer is the most common cancer among men in the UK, with more than 63,000 new cases reported annually. Early diagnosis is ‘critical’, with the 10 year survival rate over 90% for men diagnosed at stage one or two, 80% for stage three, and 18.6% at stage four, it said.
However, access to diagnostic services varies by region, but often Black men and those in deprived areas are ‘least well served’.
‘A national screening programme would reduce this unwarranted variation, ensuring more consistent access – regardless of geography or background,’ the report said.
The NSC last considered a screening programme in 2020, concluding that it was not recommended at the time due to the Prostate-Specific Antigen (PSA) test not being accurate enough to detect prostate cancer that needs treatment, and there is no single treatment that is better for patients with early-stage prostate cancer, as well as it being unclear how PSA screening impacts deaths due to prostate cancer.
In April, health secretary Wes Streeting said he was in favour of a prostate cancer screening programme for those at high risk of the disease.
He added that the NSC was looking into this, saying that decisions in this area needed to be ‘evidence-based and evidence-led’.
The Government also asked for views earlier this year to inform its men’s health strategy, which is set to be published later this year.
Currently men die on average four years earlier than women, and they are disproportionately affected by health conditions such as cancer, cardiovascular disease and type 2 diabetes, according to the DHSC.
Professor Nick James, consultant clinical oncologist at the Royal Marsden NHS Foundation Trust and Professor of prostate cancer research at the Institute of Cancer Research, said: ‘We have an urgent and undeniable problem: men at the highest risk of prostate cancer, particularly Black men, are still being diagnosed too late and facing poorer outcomes.
‘But times have changed, and the historical concerns that held back screening are being overcome by a revolution in diagnostics. We now have the advanced tools – from smarter blood tests and precision MRI to safer biopsy techniques- that allow us to screen these high-risk groups effectively and safely.
‘This isn’t about simply finding more cancers; it’s about finding the right cancers earlier. It is imperative that the National Screening Committee weighs this new evidence and recognises that we now have a clear, science-backed path to tackle these profound health inequalities.’
Oliver Kemp MBE, chief executive of Prostate Cancer Research added: ‘Our report proves without doubt that a targeted screening programme can and should be implemented now. The current system, which relies on men to come forward, is failing thousands of families every single year.
‘For an investment of just £18 per eligible person – a cost entirely comparable with breast and bowel cancer screening – we can give men at the highest risk a fighting chance of early diagnosis, when their cancer would be easiest to treat. The demands on our NHS are manageable when compared to the enormous, life-saving benefits. The evidence is clear; every year we delay costs more lives and tears more families apart.’
