The decision by the UK National Screening Committee (UKNSC) in May to reject calls for a wider prostate cancer screening program has ignited fresh controversy, with critics highlighting the absence of prostate cancer specialists and Black voices on the panel. Experts argue that this composition may have led to a decision that could cost lives.
The UKNSC's rejection of expanding the screening program has been described as 'clinical negligence' by some campaigners. A key point of contention is that the committee reportedly included no practicing urologists, the specialists who diagnose and treat prostate cancer. Campaigners suggest this lack of direct expertise meant the committee was not fully aware of recent advancements in the diagnosis and treatment of the disease.
Oscar-winning director Sir Steve McQueen has also raised concerns about the lack of Black representation on the committee. Black men are statistically more likely to develop prostate cancer and twice as likely to die from it. McQueen suggested that the presence of someone with personal experience of the disease's impact on Black families might have influenced the committee's decision.
Prostate cancer is the most common cancer in the UK, with an estimated 63,000 cases and 12,000 deaths annually. Unlike breast, bowel, and lung cancer, there is no national screening program for prostate cancer. The Daily Mail is among those advocating for a national screening program, initially targeting high-risk groups such as Black men, individuals with a family history of the disease, or specific genetic mutations.
The committee's rationale for rejecting wider screening included concerns about the accuracy of the PSA blood test, which is used to detect a marker for potential prostate cancer risk. The panel stated that treating false positives or slow-progressing cancers could lead to unnecessary risks of impotence and incontinence for men. The proposed eligibility for checks, according to the committee's decision, would be limited to men aged 45 to 61 with a rare gene mutation and a family history of breast, ovarian, pancreatic, or prostate cancer, potentially inviting as few as 1,500 men for checks.
Critics have accused the UKNSC of being outdated and resistant to change. Some senior figures on the committee have reportedly focused for years on the potential harms of screening rather than its life-saving benefits. Chris Booth, founder of the men's health charity Chaps, stated that the committee's position was based on 'discredited, deeply flawed' research, leading to a decision he called 'laughable' and one that 'will cost lives.' David James of Prostate Cancer Research also criticized the committee for being 'static and backwards-looking.' Martin Davies, chairman of the Prostate Project charity, echoed these sentiments, suggesting the committee's concerns about over-diagnosis and over-treatment were based on 'out-of-date information.'
Professor Frank Chinegwundoh, a consultant urologist, labeled the committee's decision to treat Black men and those with a family history the same as the low-risk population as 'clinical negligence.'
Health Secretary James Murray has accepted the UKNSC's recommendation in full. A spokesperson for the Department of Health and Social Care stated that the committee's decision was based on the most up-to-date NHS pathway for prostate cancer diagnoses, which includes MRI scans before biopsies. The department added that the Government is committed to improving outcomes for all men with prostate cancer and that the UKNSC will continue to review its recommendations as new evidence emerges.