Where are we with prostate cancer detection and treatment in the UK today?
Prostate cancer is now the most common cancer in the UK, according to latest figures. Analysis by the charity Prostate Cancer UK found that 64,425 men were diagnosed with the disease in 2022, compared with 61,640 with breast cancer, which had previously been the most common cancer.
What is a prostate?
The prostate is a small gland, about the size of a walnut, that is found only in men. It sits just below the bladder and helps make semen.
Prostate cancer happens when cells in the prostate start to grow in an abnormal, uncontrolled way. It’s one of the most common cancers in men, especially as men get older.
Is it always bad news?
Prostate cancer not necessarily immediately dangerous. That’s because prostate cancer can often be slow-growing and harmless, may not cause symptoms. It’s often described as something that people die ‘with’, rather than ‘from’.
Moderate risk prostate cancer is a little different. It grows faster and is likely to cause problems at a later stage. However, it is treatable if caught early.
A minority of prostate cancers are aggressive and can spread beyond the prostate to bones or lymph nodes, for example. While they are potentially life-threating, they too can often be treated, usually with long-term therapy.
What’s the outlook?
- Early-stage prostate cancer has an excellent outlook
- In the UK, around 85–90% of men survive at least 10 years after diagnosis
- When cancer is confined to the prostate, cure rates are very high
- Advanced prostate cancer is more serious, but modern treatments can often control it for years
Who is currently tested for prostate cancer and how?
A PSA blood test checks the level of prostate specific antigen (PSA) in the blood. High levels may be a sign of a prostate condition.
Routine PSA testing isn’t offered to all men on the NHS though, as it’s not completely accurate and it’s argued that it may lead to people being offered tests and treatments they don’t need. However, men aged 50+ can request a PSA blood test from their GP, who will usually discuss risks/benefits.
GPs may also test or refer if symptoms or risk factors raise suspicion.
Diagnosis
Next steps tend to be MRI screening as the first test. This aims to reduce unnecessary biopsies. If MRI suggests cancer, a targeted biopsy is performed. It may take a few weeks before you get your results.
Some hospitals are now carrying out AI-assisted MRI and rapid diagnosis pilots, allowing suspicious scans to be identified and biopsied potentially on the same day – reducing waiting times and streamlining care.
Treatment options
There are a number of treatment choices, depending on the characteristics of the cancer, the patient’s preferences and the prognosis.
Active surveillance (regular monitoring with PSA tests and imaging) is recommended for many men with low-risk, slow-growing prostate cancers to avoid unnecessary treatment.
There have been calls from charities like Prostate Cancer UK for NICE to update guidance to better standardise and encourage appropriate surveillance, as some older guidance may lead to overtreatment.
When cancer is localised and more aggressive than is suitable for surveillance, options include surgery, radiotherapy and hormone therapy.
Regular follow-up includes PSA monitoring, clinical exams and imaging as clinically indicated. Side-effect management (bladder control, sexual health, bone health) is part of long-term survivorship care.
What is the current debate in the UK about?
Some experts are arguing that existing guidance hasn’t fully incorporated newer evidence on surveillance safety, potentially leading to overtreatment.
Other voices are pushing for earlier detection tools, such as improved imaging and AI tools, and more refined targeted screening for high-risk groups.
In particular, the screening policy is under review.
The UK National Screening Committee (UK NSC) -the body that decides on national screening programmes – has, surprisingly to many, decided not to recommend a prostate cancer screening programme for all men, because evidence suggests potential harms, like overdiagnosis and overtreatment, outweigh benefits.
Instead, in its draft recommendations (Nov 2025), it proposed targeted screening every 2 years for men with confirmed BRCA1 or BRCA2 gene faults who are at higher risk. This is under consultation (January 2026) before final guidance.
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