With prostate cancer now the most diagnosed cancer in England, political momentum is growing for a national screening programme. But will the government act?
Last Thursday, the Lord Bishop of St Albans formally raised an oral question in the House of Lords, pressing the government on its plans to introduce a national screening programme for prostate cancer. This intervention comes amid a growing body of evidence showing that prostate cancer is now England’s most commonly diagnosed cancer, with cases rising sharply over the past few years.
The debate on screening is not new, but the urgency has never been greater. The latest figures from NHS England show prostate cancer has now overtaken breast cancer in diagnoses for two consecutive years, with over 55,000 men diagnosed in 2023 alone – a 25% increase since 2019.
Despite this, the UK still lacks a national screening programme for prostate cancer, unlike breast and cervical cancer. The current system relies on men seeking out PSA blood tests themselves, and GP guidance remains inconsistent. The government continues to cite concerns about overdiagnosis and overtreatment as reasons for maintaining the status quo, but with deaths from prostate cancer also alarmingly high, pressure is mounting for a rethink.
Rishi Sunak Steps In
In a move that could shape the debate, former Prime Minister Rishi Sunak has announced he is joining Prostate Cancer Research as an ambassador, explicitly backing calls for national screening for high-risk men.
“Men tend to ignore pain, hoping it’ll go away rather than going to see the GP, and that’s a part of the reason why prostate cancer is now the most commonly diagnosed cancer in males in the UK,” Sunak said, adding that trials funded under his government had already proven early detection saves lives.
This is a significant political shift. While in office, Sunak did not prioritise cancer screening expansion, but his post-premiership advocacy may put pressure on the government to act. His direct involvement in meeting scientists at Oxford BioDynamics, who have developed the EpiSwitch PSE test—which claims a 94% accuracy rate in detecting prostate cancer – suggests that screening could soon be more precise and effective than ever before.
Sunak’s involvement also raises an important political question: why is a former Prime Minister leading the charge, rather than the current government?
The Political Divide: Inaction or Policy Caution?
The issue of prostate cancer screening is fast becoming a political fault line. Despite rising cases, the UK National Screening Committee continues to advise against routine screening, citing risks of overdiagnosis and unnecessary treatment, which can lead to side effects like erectile dysfunction and urinary incontinence.
Yet, as cancer specialists and advocacy groups have pointed out, the lack of a screening programme creates massive health inequalities:
- Men from deprived areas are less likely to be tested and more likely to be diagnosed at later stages, when treatment options are more limited.
- Black men are at significantly higher risk, yet there is no targeted screening effort to address this disparity.
- GP practices vary dramatically in how often they offer PSA tests, leading to a postcode lottery in early detection.
A recent University of Exeter study revealed huge regional variations in GP testing practices, confirming that access to testing often depends more on where a patient lives than their actual risk level.
As Professor Gary Abel, who led the study, bluntly put it:
“We were surprised by the extent of the variation we saw between practices, which speaks to the ongoing lack of clarity around prostate cancer screening in the UK.”
This unclear NHS advice has left the current government in a difficult position. While Health Ministers have acknowledged that rising diagnoses require a response, there is no clear plan to introduce a structured screening programme – despite the growing weight of expert opinion.
Final Thought: The Need for Urgent Action
The data is stark – prostate cancer is now the most commonly diagnosed cancer in England, and early detection saves lives. The political question is whether the government will act on this knowledge.
With the Lord Bishop of St Albans raising the issue in Parliament, and increasing evidence of screening disparities, pressure on the government is intensifying. A national screening programme would be a big shift in UK health policy, but it could also prevent thousands of unnecessary deaths each year.
For more of Curia’s healthcare policy analysis, please click here.
