After months of debate about earlier diagnosis, targeted prostate cancer screening for men at highest risk has won the support of Rishi Sunak, who told the BBC a focused programme “could save countless lives”. The former prime minister said targeted prostate cancer screening aimed at Black men and men with a family history, aged 45–69, would be affordable and deliverable.
A new report from Prostate Cancer Research argues that targeted prostate cancer screening should combine MRI, a PSA blood test and, where needed, a biopsy. The charity estimates annual running costs of about £25m, or roughly £18 per patient, based on inviting one fifth of the eligible cohort each year and a projected uptake of 72%.
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Some clinicians urge caution. Screening can find slow-growing disease that may never cause harm, leading to treatment side effects such as incontinence and erectile dysfunction. Professor Hashim Ahmed of Imperial College said the harm–benefit balance “isn’t quite right” without further evidence.
Supporters say newer MRI-first pathways reduce unnecessary biopsies and help spot aggressive cancers earlier. Sunak, who is a patron of Prostate Cancer Research, said testing is now more reliable and called for a proactive approach. “That’s why a targeted programme could make a difference in helping save lives,” he said.
The discussion is sharpened by rising diagnoses. More than 58,000 men were diagnosed with prostate cancer in England in 2024, a 9% increase on the previous year, according to the National Prostate Cancer Audit. Risk is not evenly shared: one in four Black men will be diagnosed in their lifetime, compared with one in eight white men.
Patient voices are shaping the argument. David Bateman, 66, told how a PSA test at 59 revealed cancer that had already spread to his pelvis. He supports targeted checks for those most at risk. “If I had been screened at 50, I am sure I wouldn’t be in the position I am today,” he said.
The UK National Screening Committee is revisiting its 2019 decision not to recommend a national programme. Further detail on how screening recommendations are assessed is set out in this UK screening recommendations and evidence review.
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