More harm than good? The <scp>UK</scp> National Screening Committee's latest review of prostate cancer screening

Prostate cancer is the most common type of cancer in men but there is no national screening programme in the UK or in most other countries. The UK National Screening Committee (UK NSC) is the independent advisory body responsible for providing evidence-based recommendations to ministers in the four UK nations regarding screening programmes. Following the expansion of its remit to include targeted screening (2022) and the publication of new long-term trial data, the UK NSC launched a comprehensive review of prostate cancer screening in 2025. To inform this review, a bespoke economic model was commissioned, drawing on best available evidence and input from clinicians, technical experts, and patient representatives. The model evaluated whole-population screening and targeted strategies for men at higher risk. Based on the modelling study and consultation with stakeholders, the UK NSC recommended against whole-population screening and screening in most targeted groups. The UK NSC has recommended screening for men with a pathogenic BRCA2 variant with a family history of breast, ovarian, pancreatic, or prostate cancer. This was the only group where the UK NSC had confidence that screening would do more good than harm, primarily because prostate cancer tends to be more aggressive in this group. This narrative review describes the process taken by the UK NSC in developing its recommendations and highlights where additional evidence is still needed.