A leading Scottish charity has said it is “deeply disappointed” after the UK National Screening Committee (NSC) rejected wider prostate cancer screening.
Prostate Scotland welcomed the recommendation of a limited programme only for men with confirmed BRCA1 or BRCA2 gene variant but said it leaves many high-risk men without support.
The recommendations made today, the first time the NSC has supported any form of prostate screening, means eligible men aged 45 to 61 with these hereditary variants will be invited for checks every two years.
Yet, the committee recommended no screening invitation will be offered to other higher-risk groups, including Black men and those with a strong family history of the disease.
The decision has provoked frustration from Prostate Scotland, which warned that most men who face a heightened risk will continue to be left without an organised route to early detection.
Professor Alan McNeill, Consultant Urological Surgeon and Founding Trustee of the charity, said: “The Committee has recommended targeted screening only for men with confirmed BRCA1 or BRCA2 variants. That is a welcome first step, but it leaves many other higher-risk men without a screening offer.
“While this is welcome progress for a small group of clearly identifiable high-risk men, we are deeply disappointed that many other higher-risk men remain without a structured pathway for earlier detection – particularly Black men and those with a strong family history of prostate cancer. Although these men face higher lifetime risk and worse outcomes, they cannot currently be identified through national systems for a screening invitation. This makes clear that, for now, the priority must be strengthening risk-based PSA testing and proactive support for these groups, so that they are not left behind.”
READ MORE:
- Scottish Government calls for review of prostate cancer screening
- David Cameron reveals prostate cancer diagnosis and backs screening
- Prostate cancer: What are the symptoms and how is it treated?
The NSC, composed of clinicians and economists, has warned that population-wide screening is “likely to cause more harm than good”, arguing that current evidence does not yet support safe implementation across the general population.
As a result, the NHS is unlikely to introduce mandatory screening for men over 45.
Earlier this week, Shona Robison said the Scottish Government “always follows” the committee’s expert advice when considering new screening programmes.
But Prostate Scotland said the issue north of the border demands urgent attention as Scotland continues to record the highest proportion of late-stage prostate cancer diagnoses anywhere in the UK.
Professor McNeill warned that gaps in diagnostic access remain a major barrier: “Delivering earlier diagnosis in Scotland remains closely linked to diagnostic capacity, particularly MRI. While today’s decision focuses only on BRCA-targeted screening, Scotland will still require sustained investment in primary care support and diagnostic services to ensure that men at higher risk can access timely testing and follow-up. This remains essential given Scotland’s consistently higher proportion of late-stage diagnoses compared with the UK average.”
Highlighting the stakes further, he added: “Scotland already sees a higher proportion of late-stage diagnoses than the UK average. For us, that makes it even more important to improve awareness, GP confidence and diagnostic capacity, particularly MRI, so that men at risk can access testing early.
“Screening means the system invites you. For most higher-risk men, that still will not happen. They will continue to rely on knowing their risk, discussing this with their GP and accessing a PSA test based on their individual circumstances.”
The Scottish Government has established an expert short life working group to explore ways of improving diagnosis and reaching men most at risk.
However, the charity said today’s recommendation underscores how far Scotland remains from a system that ensures early detection for all high-risk groups.
Mr McNeill stressed that the fight for broader screening is not over, adding: “This decision is not the end of the story. Research such as the TRANSFORM trial, better data on higher-risk groups and stronger risk-based testing pathways can shift the evidence and make safe, effective screening possible for more men in future.
“At present, a population-wide screening programme cannot be safely introduced because the evidence is not yet strong enough to show that the benefits outweigh the potential harms. Continued advances in diagnostics and high-quality research will be essential to strengthening the case for broader screening in future.”
Health Secretary Neil Gray the Prostate Cancer Short Life Working Group, chaired by the Chief Medical Officer, will consider "preparedness for future National Screening Committee advice" following the end of the consultation period announced today.
Mr Gray added: Health Secretary Neil Gray said: “The Scottish Government, along with all other UK nations, relies on advice about screening programmes from the expert independent National Screening Committee and we take its recommendations seriously.
“Its advice recognises that the benefits of screening could outweigh the risks for men who are at higher risk of developing prostate cancer that requires treatment.
“We completely understand and share the desire for an effective prostate screening programme. We are also very mindful of the risk of falsely diagnosing men who do not have prostate cancer; also potentially missing some cancers; and the dangers of unnecessary tests or treatment, as the National Screening Committee set out."
