A Letter on the Urgent Need for Targeted Prostate Cancer Screening
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Adrian Ramsay MP co-signed this cross-party letter initiated by Prostate Cancer Research
Dear Secretary of State,
We write united by a belief that no man should die because of his postcode, ethnicity, or GP access.
Prostate cancer is now the most common cancer in UK men, with over 63,000 diagnoses and 12,000 deaths annually.i Today, the UK National Screening Committee (UK NSC) meets to decide on prostate cancer screening. This is a defining moment for men’s health. The Government must be ready to act so that those at highest risk – men aged 45–69 who are Black, have a family history of prostate, breast or ovarian cancer, or carry BRCA1/BRCA2 variants, all of whom face at least twice the average risk of developing prostate cancer – are no longer left behind.ii
1) A growing inequity
The latest National Prostate Cancer Audit (2025) shows inequalities are deepening. Men in deprived areas are more likely to present with advanced disease and more likely to die.iii Our current opportunistic PSA testing system is unstructured, inefficient and unfair – a postcode lottery where some men succeed because they know to ask or can pay privately, while others are turned away despite repeated requests.
Yet the data hide what cannot be modelled: eroded trust among communities who feel abandoned. Black men, already at higher risk, often believe the system fails them. Families bear devastating emotional and financial burdens from late-stage disease – costs absent from formal modelling but among the most compelling reasons to act.
2) The evidence is now clear
The evidence shows screening saves lives. The 23-year follow-up of the European Randomised Study of Screening for Prostate Cancer demonstrated a 13% mortality reduction – comparable to breast and bowel screening, with the numbers needed to screen and treat to prevent a death in line with those for existing programmes.v
Modern diagnostic pathways have transformed safety. Prostate Cancer UK’s 2024 analysis found harms reduced by 79% thanks to MRI and improved biopsy techniques.vi The Göteborg-2 trial confirmed pre-biopsy MRI halves overdiagnosis.vii
Today, the pathway is entirely different to when the UK NSC last evaluated screening: men have an MRI before any biopsy is considered; biopsies are carried out using safer transperineal methods; and low-grade cancers are far less likely to be detected – and, when they are, they are managed with active surveillance rather than treatment. Harms that once justified inaction have largely been engineered out.
These advances mean we now have the tools to deliver screening safely and effectively, yet the system is frozen waiting for next-generation trial data. Comments in The Times (3 October) suggest results from the upcoming TRANSFORM trial may take over a decade.viii Waiting would entrench inequality and allow preventable deaths. Evidence is strong enough to act now.Perfection must not be the enemy of progress.
3) Practical, affordable and efficient
Targeted screening is practical and affordable. Prostate Cancer Research’s 2025 report, Prostate Cancer Screening: The Impact on the NHS, with modelling by Carnall Farrar, shows additional annual costs would be around £25m – just 0.01% of the NHS budget – with modest workforce uplift and costs per screen comparable to existing programmes.ix Recent data also show a simplified MRI, taking 10 minutes, is as effective as current scans, opening the path to increased capacity within existing resources.x
The socio-economic benefits are substantial. Deloitte UK modelling found a five-year targeted programme would deliver a net benefit of £54m through earlier diagnosis, reduced treatment costs, and quality-of-life gains.xi Late-stage treatment averages £127,000 per patient vs. £13,000 for early-stage.xii Every delay costs lives and money.
Public support is overwhelmingly behind action: a nationally representative Healthwatch England poll of 3,575 men found 79% would attend screening if invited.xiii Tens of thousands have called on Parliament to act. We have a duty to listen, and to act.
4) Learning from the world
The UK can lead but risks falling behind. Sweden’s Organised Prostate Testing (OPT) programme shows that structured, equitable testing is achievable even without a formal programme, laying the groundwork for a future national rollout.xiv Across Europe, the EU is implementing its prostate cancer screening recommendation, and Australia is preparing to endorse risk-adapted testing for high-risk men.xv xvi
Introducing targeted screening would be a legacy-defining advance for men’s health, aligned with the ambitions of the Men’s Health Strategy and the National Cancer Plan.
Yours sincerely,
Adrian Ramsay MP co-signed this cross-party letter initiated by Prostate Cancer Research.
i prostatecanceruk.org/for-health-professionals/data-and-evidence
ii James ND, Tannock I, N'Dow J et al. The Lancet Commission on prostate cancer: planning for the surge in cases. Lancet.
2024 Apr 27;403(10437):1683-1722. doi: 10.1016/S0140-6736(24)00651-2. Epub 2024 Apr 4. Erratum in: Lancet. 2024 Apr
27;403(10437):1634. doi: 10.1016/S0140-6736(24)00748-7
iii National Prostate Cancer Audit (NPCA) State of the Nation Report 2025. London: National Cancer Audit Collaborating
Centre, Royal College of Surgeons of England, 2025. natcan.org.uk/reports/npca-state-of-the-nation-report-2025/
iv Roobol MJ, de Vos II, Månsson M, et al. European Study of Prostate Cancer Screening - 23-Year Follow-up. N Engl J Med.
2025 Oct 30;393(17):1669-1680. doi: 10.1056/NEJMoa2503223
v Vickers A. Early Detection of Prostate Cancer - Time to Fish or Cut Bait. N Engl J Med. 2025 Oct 30;393(17):1742-1743. doi:
10.1056/NEJMe2509793
vi Norori N, Burns-Cox L, Blaney N et al. Using real world data to bridge the evidence gap left by prostate cancer screening
trials, ESMO Real World Data and Digital Oncology, Volume 6, 2024, 100073, ISSN 2949-8201, doi:
10.1016/j.esmorw.2024.100073
vii Hugosson J, Månsson M, Wallström J et al. Prostate Cancer Screening with PSA and MRI Followed by Targeted Biopsy Only.
N Engl J Med. 2022 Dec 8;387(23):2126-2137. doi: 10.1056/NEJMoa2209454
ix Prostate Cancer Research. Prostate Cancer Screening: Impact on the NHS; 2025
x Ng ABCD, Asif A, Agarwal R et al. Biparametric vs Multiparametric MRI for Prostate Cancer Diagnosis: The PRIME Diagnostic
Clinical Trial. JAMA. 2025 Oct 7;334(13):1170-1179. doi: 10.1001/jama.2025.13722
xi Prostate Cancer Research. Socio-Economic Impact of Prostate Cancer Screening; 2024
xii Prostate Cancer Research, ibid
xiii healthwatch.co.uk/blog/2025-10-08/men-would-come-forward-prostate-cancer-screening
xiv Bratt O, Godtman RA, Jiborn T et al. Population-based Organised Prostate Cancer Testing: Results from the First Invitation
of 50-year-old Men. Eur Urol. 2024 Mar;85(3):207-214. doi: 10.1016/j.eururo.2023.11.013
xv EU Council Recommendation 2022/2381 and Beating Cancer Plan updates (2024). consilium.europa.eu/en/press/press-
releases/2022/12/09/council-updates-its-recommendation-to-screen-for-cancer/
xvi Prostate Cancer Foundation of Australia, Public Consultation: Draft 2025 Clinical Guidelines for the Early Detection of
Prostate Cancer. pcfa.org.au/public-consultation/
