The UK National Screening Committee has rejected calls for a widespread prostate cancer screening programme, limiting testing to a small group of high-risk men. The final guidance, published this week, narrows eligibility to men aged 45 to 61 who carry specific BRCA2 gene variants and have a relevant family history of breast, ovarian, pancreatic, or prostate cancer. This change reduces the number of men invited for screening to around 3,000 nationwide, far fewer than initial proposals.

Prostate cancer remains the most common cancer among men in the UK, with approximately 63,000 new cases and 12,000 deaths each year. Unlike breast, bowel, and lung cancers, there is currently no national prostate screening programme. Campaigners have long urged the introduction of targeted screening, particularly for men at higher risk, such as those of Black ethnicity or with a family history of the disease.

The committee’s earlier draft guidance, released last November, had suggested extending screening to about 30,000 men with BRCA1 or BRCA2 mutations. The latest recommendation excludes men with BRCA1 variants and requires BRCA2 carriers also to have a relevant family history, a significant narrowing of the criteria. As a result, groups such as Black men—who statistically face twice the risk of developing and dying from prostate cancer—remain excluded.

Critics, including patient advocates and cancer charities, expressed profound disappointment with the decision. Prostate Cancer UK emphasized the potential impact, citing the loss of more than 12,000 men annually without broader screening. Prostate Cancer Research described the recommendation as condemning thousands of men to preventable deaths. Former Prime Minister Rishi Sunak, an ambassador for Prostate Cancer Research, criticized the committee’s ruling as a missed opportunity to implement a cost-effective screening programme that could save lives.

The committee cited concerns over over-diagnosis and overtreatment as reasons to maintain caution. Screening would involve a biennial blood test measuring prostate-specific antigen (PSA) levels to identify men who require further investigation.

Health Secretary James Murray, who assumed office this month, is scheduled to meet the committee’s chair ahead of announcing whether the government will adopt or reject the guidance. Although officials expect Mr. Murray to accept the recommendation, there is an indication that emerging evidence and ongoing research could prompt future expansion of screening criteria.

The debate reflects longstanding tensions over the benefits and risks of prostate cancer screening. A major study last year found that screening reduces prostate cancer mortality by 13 percent, with one death prevented for every 456 men screened, a rate comparable to established breast and bowel programs. Nonetheless, the National Screening Committee has so far prioritized avoiding potential harms from unnecessary treatment.

While the official programme will be limited, men remain able to request PSA testing through their general practitioners. Public figures who have faced prostate cancer, including former Prime Minister David Cameron, comedian Sir Stephen Fry, and Olympian Sir Chris Hoy, have publicly called for national screening, urging the Health Secretary to reverse the committee’s recommendation and adopt a broader programme.