A national prostate cancer screening programme is not justified for all UK men, the UK National Screening Committee has advised.
The committee said mass screening would be “likely to cause more harm than good” and backed testing only for men with BRCA genetic variants.
BRCA variants are inherited DNA changes that can raise cancer risk.
Around three in 1,000 men carry these mutations. Screening for eligible men would be offered every two years between ages 45 and 61.
The recommendations also ruled out routine screening for black men, who face roughly double the risk of prostate cancer, and no screening based on family history, citing “uncertainties” due to a lack of clinical trials in black men.
Prof Freddie Hamdy, a urological surgeon in Oxford, said: “The diagnosis of prostate cancer in a healthy man is a hugely disruptive event – with potential to affect quality of life, very significantly, for many years.
“It cannot be done lightly, men need to be really well counselled and informed before the ‘snowball’ starts.
“Before you know it, you are on the operating table having your prostate removed – and we see examples of that all the time.”
Prostate cancer is the most common cancer in men and causes about 12,000 deaths across the UK each year.
The committee noted many tumours grow so slowly that a patient would need to live to 120-150 years for them to become life-threatening.
Sir Chris Hoy, the Olympic cyclist who has terminal prostate cancer, said he was “extremely disappointed and saddened” by the decision, describing tests for men with BRCA variants as “a very small step forward” that was not enough.
“I know, first hand, that by sharing my story following my own diagnosis two years ago, many, many lives have been saved. Early screening and diagnosis saves lives.”
Cancer Research UK said it supported the committee’s conclusion that screening could cause more harm than good for most groups of men.
Analysis from Cancer Research UK suggests that testing 1,000 men aged 50 to 60 would save two lives but lead to 20 being “over-diagnosed” with slow-growing tumours that do not require treatment.
Of these, 12 would likely undergo unnecessary surgery or radiotherapy, risking incontinence or erectile dysfunction.
Laura Kerby, chief executive of Prostate Cancer UK, said she was “deeply disappointed” and that the decision would “come as a blow” to tens of thousands of men.
Prof Hashim Ahmed, who is leading a major clinical trial called Transform to examine how screening could be safely extended to other groups including black men and those with family history, said: “There is a small benefit… but the harms of diagnosing, testing and treating very much outweigh those benefits.”
The recommendations are now subject to a three-month consultation before the committee gives its final advice to ministers in England, Wales, Northern Ireland and Scotland in March.
Health secretary Wes Streeting said he wants screening “provided this is backed by evidence” and would examine the evidence “thoroughly” ahead of the final advice in March.
