Professor Stephen Langley of Royal Surrey Cancer Centre, alongside Professor Frank Chinegwundoh of St George’s University of London, have written a letter to the editor of The Times in response to the article “Screening every man for prostate cancer isn’t as helpful as it sounds.”
In their letter, the professors advocate for a national targeted prostate cancer screening programme and address a key misconception in the original article—that men are routinely over-treated following a positive PSA test. They clarify that men with elevated PSA levels do not proceed directly to biopsy but firstly have an MRI and that 90% of those diagnosed with low-risk prostate cancer are managed through active surveillance. This approach avoids unnecessary treatment and ensures radical intervention is reserved for life-threatening cases.
Prostate screening
Sir, If the National Screening Committee fails to recommend the introduction of a targeted screening programme for men at the highest risk of prostate cancer, they will have made a grave and inequitable mistake (“Screening every man for prostate cancer isn’t as helpful as it sounds”, Oct 18). Black men, and those with a family history of the disease, face a significantly higher risk. To treat these men the same as the low-risk population is not evidence-based prudence; it is clinical negligence.
The narrative that the PSA blood test is a blunt and harmful instrument is a decade out of date. Today, an elevated PSA test is not a ticket to an immediate biopsy — it’s the start of a far more sophisticated diagnostic pathway. Furthermore, the UK is a world leader in minimising overtreatment. Approximately 90 per cent of men diagnosed with low-risk prostate cancer are now managed with active surveillance, a strategy that reserves radical treatment for life-threatening cancer only.
The recent Lancet Commission on prostate cancer unequivocally emphasised the need to expand testing in high-risk groups. While we wait for the perfect test to emerge, we must use the tools we already have to save thousands of lives.
Professor Frank Chinegwundoh – St George’s, University of London
Professor Stephen Langley – Royal Surrey Cancer Centre
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