28 March 2025, 07:52

By Professor Ahmed Hashim

The debate on screening for prostate cancer has been raging for over two decades.

It will continue to rage for another two decades if we do not bring new information and evidence to the table.

On one side, are over 12,000 men every year in the UK who have their lives cut short by prostate cancer. Families are devastated by these losses. Finding these cases of prostate cancer early can save thousands of lives every year. It is not just about living longer, of course. Finding and treating aggressive cancers can also reduce the impact of the cancer on quality of life as there are fewer problems with pain or bleeding or urination; we tend to use less aggressive treatments if the cancers are smaller and confined to the prostate.

On the other side, are the legitimate concerns about the harms of screening. When we talk about screening, we mean inviting almost all men between the ages of 50 and 75 years age, to have a test for prostate cancer. Currently, this test is called prostate specific antigen or PSA. It is a blood test and generally if it is above three then further tests are required such as an MRI scan and biopsy.

If these tests lead to a diagnosis of prostate cancer, men can be managed with a confusing array of different approaches that range from monitoring the cancer (active surveillance) through to radical prostatectomy (surgical removal of the whole prostate) or radical radiotherapy (radiation targeted to the whole prostate). Some men need hormones that make them castrate. The type of........

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