Weighing up the risks and benefits of prostate cancer screening | Letters

11 December 2025 at 12:58

Aamir Ahmed, Dr Graham Simpson, Adrian Bell and David Gollancz respond to a letter by a reader whose husband died of the disease after delaying getting a PSA test

It is understandable for patients suffering from a late diagnosis of prostate cancer, or families who have lost loved ones, to demand that something should be done (Letters, 5 December). I, however, respect the UK National Screening Committee’s recommendation not to screen most men using the prostate specific antigen (PSA) test.

The job of the committee was to weigh up the benefits and harms of any available test for routine screening. PSA testing, as a first step to diagnose cancer, results in false negatives and a significant number of false positives, meaning it has both low sensitivity and low specificity, making it a poor screening marker. PSA screening has been conducted in the US; there are varying estimates that, over three decades, it has resulted in more than 1 million patients receiving treatment (eg surgery or radiotherapy) they did not need.