PROSTATE CANCER SCREENING 'WOULD SAVE THOUSANDS OF LIVES'
Prostate cancer screening would save thousands of lives, a landmark study has revealed.
A national programme would save one life for every 500 men tested, according to the most comprehensive analysis conducted to date.
A major Cochrane review, considered the gold-standard in health research, found that deaths from prostate cancer fell from 16 per 1,000 men to 14 in those who were screened.
Prostate cancer is the most common cancer in the UK and is the only major form of the disease without a screening programme.
The Telegraph is campaigning for targeted screening for prostate cancer so that those most at risk – such as black men or patients with a family history of the disease – are offered prostate-specific antigen (PSA) blood tests.
This latest review was led by experts from the Heinrich Heine University (HHU), in Düsseldorf, and the University of Minnesota (UM), who analysed the results of 789,086 patients involved in six trials, five of which shaped the findings.
The men involved spanned from 45 to 80, but were primarily aged between 50 and 70.
It suggests a screening programme for men of a similar age range extrapolated across the UK would save thousands of lives.
The latest findings are a shift from a previous Cochrane review in 2013, which found that screening did not significantly reduce deaths, and shows that benefits become clearer with longer term follow-up.
The studies mostly involved white men, and so the benefits could be greater in other ethnic groups, with black men twice as likely to die from prostate cancer.
However, Dr Juan Franco of HHU, the review’s first author, highlighted other studies which estimate the overdiagnosis rate to be between 20 per cent to 50 per cent for prostate cancer.
He described the PSA as “an imperfect test” and stressed there are “many kinds” of prostate cancer.
“There are very aggressive kinds that can cause death, but there’s also very benign forms that take the whole life to grow and perhaps never cause any problems for men,” Dr Franco said.
“That is what we call overdiagnosis and that is another side effect related to the screening.”
Recommended
As a prostate cancer surgeon, this is what I wish every man knew about the disease
Dr Philipp Dahm, the senior author at UM, said the findings “support a conversation about PSA screening”.
“With new data now available, we can now say with moderate certainty that PSA screening reduces prostate cancer deaths in men with a sufficient life expectancy,” he said.
“This suggests that for the right patient – someone who is well-informed, has a good life expectancy and understands the full implications of screening – there is now a reasonable evidence base to support a conversation about PSA screening.”
Dr Dahm added: “I don’t want to take away from what guideline developers will say, but with these results I think more guideline developers may recommend prostate cancer screening for men that have certain characteristics, the most important one being that they have a long life expectancy.”
Dr Franco said it was “not a blanket endorsement of universal screening”.
There is currently no screening programme for prostate cancer in the UK, although men over 50 can request a PSA test from their GP.
In November, the UK national screening committee (UKNSC) said it would not recommend screening using the PSA test because it “is likely to cause more harm than good”.
It only recommended that men with BRCA1 and BRCA2 genetic mutations – which puts them at far higher risk of prostate cancer – should be screened every two years, between the ages of 45 and 61.
The trials included in the latest research did not look at impacts on quality of life, such as complications from biopsies, sexual dysfunction and urinary problems.
However, David James, director of patient projects and influencing at Prostate Cancer Research, said the review “adds significant weight to the prostate cancer screening debate because it shows increasingly clearly that screening does save lives”.
“What is particularly striking is that the benefits of screening become more apparent with longer follow-up. Some of the longest-running studies now suggest substantially greater reductions in prostate cancer deaths over time than were visible in earlier analyses,” he said.
“At the same time, the way we diagnose and treat prostate cancer has changed dramatically since many of these trials began. Much of this evidence comes from an era before MRI-led pathways, and before safer, more targeted biopsies and active surveillance that are specifically designed to reduce unnecessary harm.
“The question remains whether the UK is willing to properly evaluate modern, risk-adapted prostate cancer screening using today’s evidence and diagnostic tools, instead of continuing to assess it through the lens of decades-old clinical practice.”
Meanwhile, Dr Ian Walker, executive director of policy at Cancer Research UK, said the study “highlights why there isn’t currently a widespread screening programme in the UK”
“Unfortunately, the test currently used to detect prostate cancer is not effective enough,” he said.
“Whilst this review does highlight that the test could save one to two lives from prostate cancer for every 1,000 men screened, it also shows that around 30 more men could be diagnosed with the disease, many of whom would never have been harmed by their disease and could go on to have unnecessary treatment with long-term impacts like the loss of bladder control and erectile dysfunction.”
2026-05-14T23:05:37Z
