Prostate cancer has officially become the most prevalent form of the disease in the United Kingdom, surpassing breast cancer, according to recent analysis. This significant shift is accompanied by a sharp increase in diagnoses, with 64,425 men identified with prostate cancer in 2022, the latest year for which figures are available. This figure contrasts with 61,640 breast cancer diagnoses and represents a substantial 24 percent rise from the 51,823 prostate cancer diagnoses recorded in 2021.

The charity Prostate Cancer UK attributes a 42 percent surge in diagnoses over the past decade to heightened awareness campaigns led by charities, the NHS, and influential public figures. The Daily Mail has also actively campaigned for earlier diagnosis and comprehensive screening programmes. The disease's status as the most common cancer was initially established in England last January, with new data from Scotland, Wales, and Northern Ireland now confirming its UK-wide prevalence.

Despite the rising incidence, a contentious debate surrounds the implementation of population-wide screening. The UK National Screening Committee (UKNSC), an advisory body to the Government, issued a draft recommendation in December stating that prostate cancer screening should not be routinely available for the vast majority of men. The committee argued that population screening using the prostate specific antigen (PSA) test is "likely to cause more harm than good," citing concerns over potential unnecessary treatments for slow-growing or harmless tumours, which can lead to severe side-effects such as incontinence and erectile dysfunction. The UKNSC's recommendation was limited to screening men with BRCA1 and BRCA2 genetic mutations, who face a significantly higher risk, every two years between the ages of 45 and 61.

This decision has met with surprise and criticism from various quarters. Health Secretary Wes Streeting expressed his astonishment and is currently reviewing the findings. Prominent figures who have been diagnosed with prostate cancer, including Olympic gold medallist Sir Chris Hoy, former prime minister Lord David Cameron, broadcaster Sir Stephen Fry, and actor Sir Tony Robinson, have spoken out against the UKNSC's recommendation. While Prostate Cancer Research supports more screenings, Cancer Research UK aligns with the screening committee's decision.

Prostate Cancer UK voiced its disappointment but remains resolute in its efforts to challenge the recommendation through further research and evidence. The charity is currently conducting a major clinical trial, with results expected within two years, investigating whether combining the PSA test with other diagnostics, such as rapid MRI scans, could justify a recommendation for population-wide screening for all men.

Chiara De Biase, director of health services, equity and improvement at Prostate Cancer UK, emphasized the urgency of addressing deep-seated inequities in diagnosis and treatment across the country. Analysis by Prostate Cancer UK reveals that men in areas of higher deprivation are 29 percent more likely to be diagnosed with advanced, spread disease. Furthermore, while diagnoses are increasing in Scotland, men there are more prone to late-stage diagnosis (31 percent) compared to their counterparts in England (21 percent). De Biase stated, "Prostate cancer is now the most common cancer in the UK, but despite this, men are facing deeply unfair inequities across the country, and their experiences vary hugely based on where they live. We urgently need an early detection programme that will address these regional inequities."

Current NHS guidelines are deemed "outdated" by Prostate Cancer UK, preventing General Practitioners (GPs) from proactively engaging with high-risk men, such as those with a family history or Black men, to discuss their risk and offer the PSA test. Sir Chris Hoy passionately advocated for systemic change, highlighting that early detection makes prostate cancer curable. He urged, "What we need now is action to change the system, to enable more men to be diagnosed earlier and stop them getting the news I got. We need GPs to be able to proactively speak to men at highest risk...and discuss the PSA blood test to check for signs of cancer at an earlier stage. It shouldn't be only men's responsibility to make these potentially lifesaving conversations happen." The charity encourages all men to use its free, anonymous online risk checker to understand their individual risk and rights, a tool already utilized by four million men.

The debate over the PSA test's reliability continues among experts. Critics argue that a high PSA level does not always indicate cancer, and some men with cancer may have a normal PSA result. They also point to the risk of unnecessary treatments following positive tests, leading to adverse side-effects. However, other experts maintain that current evidence supports wider testing, underscoring the ongoing need for robust research to inform future screening policies.