The UK National Screening Committee (UKNSC) has drawn sharp criticism after it rejected a proposal for a wider prostate cancer screening program, a decision that has been described by some experts as 'clinical negligence.' A key point of contention is that the committee responsible for the decision reportedly included no practicing specialists in prostate cancer and notably, no Black members.
Prostate cancer is the most common cancer in the UK, affecting 63,000 men annually and causing 12,000 deaths. Despite this, it lacks a national screening program, unlike breast, bowel, and lung cancers. Campaigners, including the Daily Mail, advocate 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 UKNSC's decision was made despite advancements in diagnosing and treating the disease. The committee ruled that the PSA blood test, used to detect a marker for prostate cancer risk, is not sufficiently accurate for widespread use. They cited concerns that treating false positives or slow-progressing cancers could lead to unnecessary risks of impotence and incontinence for affected men.
However, critics argue that the committee's composition and reliance on potentially outdated research led to a flawed conclusion. Chris Booth, founder of the men's health charity Chaps, stated that the lack of practical experience meant the committee's position was based on 'discredited, deeply flawed' research, resulting in a decision that 'will cost lives.' David James of Prostate Cancer Research accused the committee of being 'static and backwards-looking,' urging it to 'adapt and modernise its approach.'
Oscar-winning director Sir Steve McQueen highlighted the absence of Black members on the committee, pointing out that Black men are more likely to develop prostate cancer and twice as likely to die from it. He suggested that a different decision might have been reached had the committee included someone with personal experience of the disease's impact on Black families.
Professor Frank Chinegwundoh, a consultant urologist at Barts Health, deemed the committee's decision to treat Black men and those with a family history the same as the low-risk population a 'grave' mistake amounting to 'clinical negligence.'
In contrast, the European Association of Urology has supported wider prostate cancer screening in the EU. The UKNSC's membership guidelines state it 'normally includes… practising clinicians who have expertise in one or more relevant areas,' a standard that, according to critics, was not met in this instance regarding prostate cancer specialists.
The Department of Health and Social Care confirmed that Health Secretary James Murray accepted the UKNSC recommendation in full. A spokesperson stated that the committee's decision utilized the most current NHS pathway for prostate cancer diagnoses, which incorporates MRI scans before biopsies, and that recommendations are kept under active review as new evidence emerges.