A landmark study spanning 23 years has revealed that screening men for prostate cancer could save thousands of lives, reducing the risk of death from the disease by 13 percent. The research highlights a “sustained reduction” in mortality over the follow-up period, showing that the benefits of screening now outweigh potential harms more clearly than ever before. Researchers say the findings support a more “targeted” approach to prostate cancer screening, one that saves lives while minimizing unnecessary treatment.

The study found that one prostate cancer death was prevented for every 456 men invited for screening, and one life was saved for every 12 men diagnosed with the disease. Commentators noted that these figures are “comparable to those seen with breast or bowel cancer screening.” The findings come amid ongoing advocacy, including the Daily Mail’s campaign, for a national prostate cancer screening program focused initially on high-risk men. The UK National Screening Committee, which advises the government on screening policies, is currently reviewing new evidence on prostate cancer diagnostics and is expected to publish its recommendations later this year.

Led by experts at the University Medical Center Rotterdam, the study evaluated the risks and benefits of screening among 162,000 men across eight European countries, 72,000 of whom were invited for screening. While acknowledging the risk of overtreatment, where men might undergo therapy for slow-growing tumors that may never cause harm, researchers emphasize that the “harm-to-benefit profile” of screening is now more favorable than previously estimated. They credit major advancements in diagnostic tools and treatments since the trial began, particularly the use of MRI scans before biopsies, which help doctors distinguish between cancers that need treatment and those that can be safely monitored.

The researchers underscored the need for a more focused screening strategy, stating: “These findings highlight the need for a more targeted approach to prostate cancer screening, one that identifies population subgroups most likely to benefit from early detection while reducing unnecessary interventions among those at highest risk of over-diagnosis.” The study utilized the prostate-specific antigen (PSA) blood test, which is currently used to detect potential prostate abnormalities, including cancer and enlargement.

In the UK, routine PSA testing is not part of the NHS’s standard screening program. However, men can request a PSA test through their GP if they show symptoms or are over 50. Professor Nick James, a leading prostate and bladder cancer specialist at The Institute of Cancer Research, London, commented that the latest analysis from the European Randomised Study of Screening for Prostate Cancer (ERSPC) strengthens the evidence base for PSA-based screening. He added that the known risks, such as over-diagnosis and overtreatment, can now be greatly reduced through modern techniques like MRI pre-biopsy and improved patient monitoring. Moreover, he noted that the side effects of modern surgery and radiotherapy are far less severe than those recorded during the original trial, further supporting the case for national screening.

Prostate cancer remains the most common cancer among men in the UK, with around 63,000 diagnoses and 12,000 deaths each year. Early detection is critical: nine in ten men diagnosed at an early stage survive for at least ten years, compared with fewer than one in five whose cancer is detected late, after it has spread.

David James, Director of Patient Projects and Influencing at Prostate Cancer Research, strongly urged immediate government action: “For years, men have been told we can’t have a national screening program because PSA testing does more harm than good. This trial shows that simply isn’t true. The balance between the benefits and harms is far better than previously suggested, screening saves lives while minimizing side effects.” He continued, “Prostate cancer is the most common cancer in men and the second biggest male cancer killer in the UK. No man should die just because his cancer wasn’t found in time. We have the technology, the treatments, and now the overwhelming evidence. It’s high time for screening in the UK.”

Dr. Matthew Hobbs, Director of Research at Prostate Cancer UK, echoed the study’s importance, noting its crucial role in shaping the National Screening Committee’s decision later this year, particularly regarding men at higher risk, such as black men and those with a family history of the disease.

The push for screening has also gained political momentum. Former Prime Minister Rishi Sunak and Labour’s Deputy Prime Minister David Lammy have both voiced support for targeted screening of high-risk men, citing a report estimating the cost of such a program at just £18 per patient. Health Secretary Wes Streeting has also endorsed the idea of a national prostate cancer screening program, signaling strong political will for its implementation. The NHS already offers national screening programs for breast, bowel, and cervical cancers — and experts argue it is time prostate cancer joined that list.