PSA tests measure the level of prostate-specific antigen in the blood and are commonly used by the NHS to detect prostate problems
The Department of Health and Social Care has issued a major update following thousands of Brits’ calls for changes in prostate cancer testing as part of a parliamentary campaign. The petition aimed to make PSA testing available to anyone at higher risk, at a time when prostate cancer is the most prevalent form of the disease among men in the UK.
PSA tests measure the level of prostate-specific antigen in the blood and are commonly used by the NHS to detect prostate problems. However, these check-ups aren’t routinely provided within the health service, nor are they included in a national screening programme.
Although the petition claimed that it’s ‘time to review NHS guidelines’ and ‘invest in an early detection programme’, the Government department said it has ‘no plans’ to do so with PSA tests. Its justification was largely focused on current ‘limitations’ in PSA testing, which make it inadvisable for screening ‘men with no symptoms’.
In an online update, posted on September 12, the Department of Health and Social Care said: “The Government has no current plans to require PSA blood tests to be proactively offered to men at highest risk of prostate cancer, because the evidence does not support this.”
The response continued: “Whilst it is recognised that the Prostate Specific Antigen (PSA) test can be a valuable diagnostic tool in certain contexts, such as for men who present with symptoms, its limitations mean that it is not currently recommended for population-level screening, i.e. screening men with no symptoms.
“This is because elevated PSA levels can be caused by non-cancerous conditions such as benign prostatic hyperplasia (BPH), prostatitis, or recent physical activity. This results in high rates of false-positive results, leading to unnecessary anxiety, invasive biopsies, and potential overtreatment.
“For example, a diagnosis via a biopsy and treatment (prostatectomy and radiotherapy) carries risks of life-changing harm, such as urinary and faecal incontinence, sexual dysfunction, as well as a smaller but serious risk of sepsis.”
The Government department also said that some prostate cancers do not trigger elevated PSA levels, which may potentially lead to false-negative results, providing ‘deceptive reassurance’. In turn, the UK National Screening Committee, which guides the department, ‘currently considers that these potential risks outweigh the benefits of population screening’.
The online response added: “As part of its commitment to keep its recommendations under review, the UK NSC has commissioned a new evidence review for prostate cancer screening. This covers modelling of the clinical effectiveness and cost of several approaches to prostate cancer screening.
“It includes different potential ways of screening the whole population, and targeted screening aimed at groups of people identified as being at higher-than-average risk, such as black men or men with a family history of cancer.
“The modelling and evidence reports are now complete, and are being considered by the UK NSC and experts. Subject to no further revisions being required, the UK NSC plans to hold a public consultation towards the end of 2025. After this, the UK NSC will make a recommendation. Ministers will then be asked to consider whether to accept the recommendation.”
Despite this, the Government has invested £16 million in collaboration with Prostate Cancer UK (PCUK) to initiate its £42 million TRANSFORM trial. This nationwide study seeks to compare the most effective tests for detecting prostate cancer, marking the largest prostate cancer screening trial in 20 years.
As part of this, the department has ensured that one in 10 participants invited to take part in the trial will be a Black man, acknowledging the higher risk Black men face of being diagnosed with prostate cancer.
The online response added: “The Government agree that too many men are dying from prostate cancer. Any death from cancer is a tragedy, which is why this Government will publish a National Cancer Plan later this year. The Plan will have patients at its heart, with the goal to reduce the number of lives lost to cancer.”
The petition, titled ‘Review and fund improved detection and diagnosis of prostate cancer’, has so far garnered just over 12,000 signatures. Should it reach more than 100,000, it will be considered for a debate in Parliament.
You can view the petition in full here.