Prostate Scotland notes the recommendation from the UK National Screening Committee (NSC) on Friday 28 November 2025 to introduce targeted prostate cancer screening only for men with confirmed BRCA1 or BRCA2 gene variants.
While this represents an important first step towards screening for a specific group of men, it will be a significant disappointment for many other higher-risk men who remain without an offer of testing. This includes Black men and men with a strong family history of prostate cancer, who face higher lifetime risk and worse outcomes but currently cannot be reliably identified through national systems for a screening invitation.
Professor Alan McNeill, Consultant Urological Surgeon and Founding Trustee of Prostate Scotland, said:
“While this is welcome progress for a small group of clearly identifiable high-risk men, we are deeply disappointed that many other higher-risk men remain without a structured pathway for earlier detection – particularly Black men and those with a strong family history of prostate cancer. Although these men face higher lifetime risk and worse outcomes, they cannot currently be identified through national systems for a screening invitation. This makes clear that, for now, the priority must be strengthening risk-based PSA testing and proactive support for these groups, so that they are not left behind. Delivering earlier diagnosis in Scotland remains closely linked to diagnostic capacity, particularly MRI. While today’s decision focuses only on BRCA-targeted screening, Scotland will still require sustained investment in primary care support and diagnostic services to ensure that men at higher risk can access timely testing and follow-up. This remains essential given Scotland’s consistently higher proportion of late-stage diagnoses compared with the UK average. Scotland already sees a higher proportion of late-stage diagnoses than the UK average. For us, that makes it even more important to improve awareness, GP confidence and diagnostic capacity, particularly MRI, so that men at risk can access testing early. Screening means the system invites you. For most higher-risk men, that still will not happen. They will continue to rely on knowing their risk, discussing this with their GP and accessing a PSA test based on their individual circumstances. This decision is not the end of the story. Research such as the TRANSFORM trial, better data on higher-risk groups and stronger risk-based testing pathways can shift the evidence and make safe, effective screening possible for more men in future. At present, a population-wide screening programme cannot be safely introduced because the evidence is not yet strong enough to show that the benefits outweigh the potential harms. Continued advances in diagnostics and high-quality research will be essential to strengthening the case for broader screening in future.”
Key facts about today’s NSC recommendation:
• The NSC has recommended a targeted screening programme only for men with a confirmed BRCA1 or BRCA2 variant.
• Screening will take place every two years for eligible men aged 45 to 61.
• The Committee has not recommended screening for the wider population.
• The Committee has not recommended screening for other high-risk groups, including Black men and men with a family history of prostate cancer, due to current evidence gaps and the inability to reliably identify and invite these groups through national systems.
• This is the first time the NSC has recommended any form of prostate cancer screening, reflecting progress in diagnostic safety and accuracy.
For more information, visit www.prostatescotland.org.uk
