Prostate Cancer Screening

Monday 26th October 2026 Westminster Hall

16:30

[John Lamont (Berwickshire, Roxburgh and Selkirk) (Con)]

I beg to move,

That this House has considered e-petition 751472 relating to prostate cancer screening.

It is a pleasure to serve under your chairmanship, Dr Murrison. I begin by thanking David James, director of patient projects and influencing at Prostate Cancer Research, for creating the petition, and the 101,932 people who supported it, including 195 in my constituency in the Scottish Borders.

[Dame Harriett Baldwin (West Worcestershire) (Con)]

Will my hon. Friend thank the high number of my constituents who signed the petition, putting West Worcestershire at the top of list for the number of signers who brought it before Parliament? Will he also praise the work of the Graham Fulford Charitable Trust which, working with the Worcestershire Ambassadors, brings so many free prostate cancer screening opportunities to people in my constituency?

[John Lamont]

I am grateful to my hon. Friend for making that point. It is a testament to the importance of the issue not just to her constituents—given the number who signed the petition—but to all our constituents who signed it that so many see the need for the Government to address this matter. All the charities do important work in the area.

[Nick Thomas-Symonds (Torfaen) (Lab)]

Will the hon. Gentleman give way?

[John Lamont]

I will make some progress, if I may, to develop a few arguments. I will take a couple of interventions, but I am conscious of the number of colleagues who are keen to speak.

The petition argues:

“Targeted screening for all high-risk men should be the starting point for building a screening programme that can ultimately protect all men.”

It also questions the decision to offer screening exclusively to men with BRCA1 or BRCA2 genetic variants.

Since the petition was launched, the UK National Screening Committee recommendation has narrowed, and the Government have now accepted screening for a a smaller group than the petition sought. The questions for us today are: who should be included? Why have other high-risk groups been excluded? And what evidence would justify widening the programme?

Prostate cancer is the most commonly diagnosed cancer in men in the United Kingdom. More than 68,000 men are diagnosed annually, with over 12,000 dying from the disease each year. Patient survival hinges heavily on when it is diagnosed: if it is at stages 1 or 2, nearly 100% of men survive for five years or more, whereas if it is at stage 4, only about half live for five years or more.

Sir Chris Hoy, Scotland’s most decorated Olympian, knows this better than anyone. He was diagnosed in 2023, in his 40s, after a scan for shoulder pain. He had no prostate cancer symptoms at all, yet by then the cancer had spread to his bones and was terminal. His father and grandfather both had prostate cancer. Under the programme that the Government have now accepted, a family history like his would not, on its own, qualify a man for screening.

Last year, the broadcaster Dermot Murnaghan was diagnosed with stage 4 prostate cancer and, sadly, died in July this year. He said that he “fell through the gaps”, having assumed that the regular health checks he received would include a PSA—prostate-specific antigen—test. They did not. His message to other men was simple:

“Get the test. Insist on the test.”

Risk is not evenly distributed—age, family history, genetics and ethnicity all matter. One in eight men will develop prostate cancer during their lifetime, with the proportion rising to around one in four for black men. That is why the petition argues for screening to begin with men already known to be at greater risk.

[Nick Thomas-Symonds]

The hon. Gentleman speaks powerfully on behalf of his constituents in Scotland; I have had many emails on this issue from my constituents in Wales. Does he agree that when it comes to testing, all men are at high risk? It should happen not just in England but all around the United Kingdom.

[John Lamont]

The right hon. Gentleman makes an important point. I will come on to the importance of ensuring that we get a UK-wide approach, because there are subtle differences among the devolved nations.

The UK Government decision to accept the UK NSC’s final recommendation in England—to provide a PSA test every two years to men aged 45 to 61 with pathogenic BRCA2 variant and a relevant family history of breast, ovarian, pancreatic or prostate cancer—is a significant step forward, and roll-out is expected from 2027. BRCA1 carriers, however, are excluded, and BRCA2 carriers must also meet the family history criterion. The Department of Health and Social Care estimates estimates that only around 1,500 men in England will be eligible, and acknowledges that most prostate cancer cases will therefore fall outside the programme.

The final recommendation also falls well short of what Members from across the House have called for. In November 2025, a cross-party letter signed by more than 120 MPs, hand delivered to the Health Secretary by my right hon. Friend the Member for Richmond and Northallerton (Rishi Sunak), called on the Government to act for the men at greatest risk: black men; men with a family history of prostate, breast or ovarian cancer; and BRCA1 and BRCA2 carriers. Its message was clear: perfection must not be the enemy of progress. The concern raised by those MPs reinforces the central question that the petition addresses: is the current screening programme too narrow?

[Edward Morello (West Dorset) (LD)]

As somebody who has the BRCA2 genetic abnormality, I will be eligible for the extra screening that the hon. Gentleman outlined. Unfortunately, too many men are delayed in getting screened, especially in rural and deprived areas, and the delays result in prostate cancer being identified far later. Although I am grateful to the Government for including me in the screening, does the hon. Gentleman agree that more must be done to inform men of the need for regular screening to avoid it being caught so late?

[John Lamont]

The hon. Member makes an important point about awareness and the challenge in rural areas. I will come to that later in my speech.

I am pleased that my right hon. Friend the Member for Richmond and Northallerton is present, having done so much to advance this issue. As Prime Minister, his Government backed the £42 million Transform trial, providing £16 million of Government funding to examine different approaches to prostate cancer screening.

For the benefit of Members who are not aware, Transform is the largest prostate cancer screening trial in two decades. Designed and led by Prostate Cancer UK, with Government funding through the National Institute for Health and Care Research, it is comparing combinations of PSA blood tests, fast MRI scans and genetic saliva tests to find the safest and most effective way to detect prostate cancer before it becomes incurable. Crucially, it is designed to include far more black men than previous trials. With further Government funding announced this year, it is now worth around £60 million, and its first-stage results are expected before the end of 2027.

My right hon. Friend has since become an ambassador for Prostate Cancer Research and has called for a targeted national screening programme for the groups most at risk. Prostate Cancer Research says that the final UK NSC recommendation

“falls short of what is needed”,

arguing that too many high-risk men remain outside the programme.

[Alistair Strathern (Hitchin) (Lab)]

I echo the hon. Gentleman’s praise for the former Prime Minister’s tireless campaigning on this issue. I have been deeply moved by many of my constituents whose lives were saved by early screening; all too often, though, that was the result of charity initiatives, because it was not available on the NHS. The hon. Gentleman rightly mentioned a lot of the advanced research in this area, which highlights every day how important screening is. Does he agree that the Government must continue to review the issue and see whether widening the screening criteria could save more lives?

[John Lamont]

The hon. Member is right. There is so much work and research going on in this area, and it is imperative that the Government acknowledge that work and react once more informed evidence becomes available.

The petitioners argue that the UK NSC has “fixated on potential harms” and underweighted the benefits of earlier detection, but there are good reasons why screening programmes face a higher evidential threshold. A raised PSA level does not by itself diagnose prostate cancer, but can cause anxiety and lead to further investigation. Screening can also result in overdiagnosis and unnecessary treatment, which can cause lasting harms. Prostate Cancer Research challenged the draft modelling, arguing that it relied too heavily on older evidence and did not adequately reflect modern MRI-led diagnostic pathways. The UK NSC says it considered those criticisms and updated its modelling before reaching its final recommendation.

[Stuart Anderson (South Shropshire) (Con)]

I thank all my constituents who have contacted me about this vital point. Community diagnostic centres offer great resources to speed up screening. Does my hon. Friend agree that more emphasis should be put on those centres, particularly in rural areas like South Shropshire?

[John Lamont]

My hon. Friend makes a crucial point about the importance of testing centres being available in rural areas, and about how community-based testing centres link into the NHS and the research that is being carried out.

There remains significant disagreement about the scale of harm. The UK National Screening Committee estimates that for every 1,000 men offered screening, up to 20 could be overdiagnosed, while around two lives are extended. Analysis by Prostate Cancer Research of more contemporary, MRI-led studies estimates that, roughly, for every two lives saved, three men are overdiagnosed. The updated Cochrane review published in May found that for every 1,000 men screened, PSA-based screening is likely to reduce prostate cancer mortality by around two deaths, while questions about overdiagnosis and treatment-related harms remain.

When I met researchers from the Transform team, they highlighted an important nuance: MRI has reduced unnecessary biopsies, but it has not yet been shown that those diagnostic advances sufficiently reduce overtreatment. Questions also remain about how organised screening would interact with the PSA testing that is already taking place, and about screening black men, with the UK NSC saying it has insufficient evidence to determine

“whether screening would cause more good than harm.”

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

I declare an interest: my wife, Olivia, works as a radiographer in the national health service. The thrust of the Government information given to all our constituents is about catching cancer as early as possible; part of the dilemma is that the Government position on prostate cancer screening seems to run against that. Over the weekend, I had a dozen emails from constituents who either have had prostate cancer or have family members who have been touched by it. Does my hon. Friend agree that, given that dichotomy, the Government should perhaps play it a little safe and be prepared to look at this again?

[John Lamont]

My right hon. Friend makes an important point. My ask is that the Government continue their engagement, but also keep assessing the evidence and information coming forward, so that patients are given the best possible opportunity for survival.

The uncertainty around screening matters the most for black men, as one in four will develop prostate cancer and they are around twice as likely to die from it, but rather than being offered screening, they are being invited to take part in a trial. Transform has received up to a further £18 million to directly test several relevant questions, and to ensure that if stage 1 of the project is successful, all eligible black men aged between 45 and 74 will be invited to stage 2. Researchers told me that useful stage 1 evidence should be available before the long-term trial is complete, and will be fed back to the UK NSC.

As the MP for the Scottish Borders, I want to highlight Scotland’s experience. The Scottish Prostate Cancer Initiative, supported by Sir Chris Hoy, Sir Tom Hunter, Professor Sir Chris Evans and Kenny Logan, aims to offer free PSA tests to 25,000 men aged 40 to 80 during 2026. Sir Chris described the initiative as

“a major step forward for prostate cancer testing.”

In May, 313 men were tested in Hawick and 515 men were tested in Galashiels, meaning that across two days 828 men in my constituency were tested. The initiative is not an NHS screening programme, but its community-based model may offer useful lessons about access, uptake and reaching men who might otherwise be missed. That matters, because inequalities remain stark. Analysis from the NHS, National Services Scotland and Macmillan Cancer Support found that men in the most deprived areas had a 98% higher risk of death from prostate cancer than those in the least deprived areas.

I hope the Minister can address several points. First, will she commit to independent expert scrutiny of the UK NSC modelling, and to publish the findings and the Committee’s response in full? Secondly, as stage 1 of Transform produces significant new evidence, particularly on the screening of black men, will the Government ask the UK NSC to review its recommendation? Thirdly, how will the NHS proactively identify eligible BRCA2 carriers, particularly men whose genetic risk is not already known?

Fourthly, what lessons on improving access to testing can be drawn from community-based initiatives in Scotland? Fifthly, what discussions has the Minister had with the Scottish Government and the other devolved Governments to ensure that a man’s access to screening does not depend on which side of the border he lives on? Finally, what will the Government do to make sure that the many men who fall outside the programme know they can ask their GP for a PSA test and receive clear, balanced information when they do?

[Tim Farron (Westmorland and Lonsdale) (LD)]

I had the joy of spending time with the Kendal and South Lakes prostate cancer support group just a few weeks ago. Like the hon. Gentleman and me, its members are massively in favour of increased screening and making sure there is default screening for men over 50. Does the hon. Gentleman also think the Government need to be aware that if we test more people earlier and identify cancers earlier, more people can be treated? Does he believe the Government have done enough work, both north of the border and in the UK Parliament, to ensure that we have sufficient capacity for surgery, radiotherapy and chemotherapy so that we can treat the people who are diagnosed?

[John Lamont]

That is a key point, because not everybody who is diagnosed with prostate cancer will necessarily need further treatment. Some people will not die of prostate cancer but will die with prostate cancer. The challenge for the Government is getting the balance right between when it is appropriate to test and treat and when it is not.

I am conscious that many Members want to speak, so let me conclude. Screening is not simple. Finding more cancer is not automatically the same as saving more lives, but legitimate concerns about overdiagnosis should not prevent us from asking whether advances in diagnosis have changed where the balance now lies. More than 100,000 people have asked Parliament to consider targeted screening for men at higher risk. Since they signed the petition, targeted prostate cancer screening has entered policy for the first time. That is an important first step. The question now is how and when the boundary should move as the evidence develops.

The evidence I heard when preparing for this debate points both ways. Earlier detection could save lives, but questions remain over whether modern screening can reduce past harms. The Transform trial should help to provide the answers. When it reports, the Government must be ready to act quickly; that is what the petitioners asked for and what I hope the Minister will commit to. I look forward to hearing from her and from colleagues.

[Several hon. Members rose—]

[Dr Andrew Murrison (in the Chair)]

Order. Colleagues will note that the debate is vastly oversubscribed, and we will not be able to get everybody in. There will be a two-minute time limit on speeches and Front-Bench speeches will begin at 5.28 pm.

16:45

[Warinder Juss (Wolverhampton West) (Lab)]

It is a pleasure to serve under your chairship, Dr Murrison.

The early stage of prostate cancer frequently produces no symptoms, which means many men are diagnosed only after the cancer has progressed. Screening offers the possibility of detecting the disease before symptoms develop. The strongest case for targeted screening is for high-risk men. That includes black men, who are twice as likely to develop prostate cancer as non-black men—one in four black men will be diagnosed with prostate cancer during their lifetime—and they face a higher risk of dying from the disease. Equal treatment is not necessarily equitable treatment, because black men face a substantially higher risk of developing and dying from prostate cancer. Prostate cancer screening should certainly be available to all black men.

My constituent Simeon Greene shared his experience of prostate cancer and the devastating impact the disease can have on black men and their families. He is a black man of African-Caribbean heritage and the youngest of four brothers. Tragically, all four brothers were diagnosed with prostate cancer before the age of 50, and all three of Simeon’s brothers have now died from the disease. The impact on his family has extended to the next generation; the son of Simeon’s eldest brother was diagnosed with prostate cancer at the age of just 39. His family’s experience demonstrates the devastating consequences of prostate cancer, particularly when it affects men at such a young age. We owe it to families like Simeon’s to amplify efforts to raise awareness, encourage early conversations about prostate cancer, and improve earlier detection and access to appropriate care. No family should have to endure what Simeon’s family has.

We also need to provide greater support for trusted community organisations, which can play a vital role in raising awareness of prostate cancer and encouraging men to seek advice. The Wolves Foundation in my constituency recently hosted an event which used the reach of football to get men talking about the disease. They worked with local NHS specialists and those with personal experience of prostate cancer.

16:45

[Rishi Sunak (Richmond and Northallerton) (Con)]

It is a pleasure to serve under your chairmanship, Dr Murrison. I declare an interest as an ambassador for Prostate Cancer Research. In the work that I do for that charity I have spent a lot of time in the community talking to people affected by prostate cancer and those organising drives, and I am humbled by the many men I have met for whom diagnosis has come far too late to make a difference to their life, but who have chosen to dedicate themselves to this issue and to raising awareness. I think that is extraordinary of them and, as I said, humbling. The most important thing we can do to honour them is to make sure no one else loses a father, grandfather or brother to this cruel disease.

I, like many other campaigners, was disappointed with the decision of the National Screening Committee. The Budget is not until Wednesday, but colleagues know I like numbers, so I dove into the model behind that decision and found a few issues that I hope the Minister will go back and have a look at. The model assumed treatment costs of around £27,000, but most independent estimates are far higher. The model assumed that only about a quarter of men received the most advanced drugs—again, audit figures suggest that twice as many do—and that they would not receive that treatment for more than three years, when the evidence is that they receive it for longer. All those gaps understate the positive case for screening that has been verified by the independent York Health Economics Consortium.

Further to that, we heard about the concern regarding overtreatment, but modern diagnostic pathways offer ways to reduce unnecessary treatment and diagnosis. Given the time available to us, we do not need to go into all the details, but the evidence this year from the Cochrane review that looked at 800,000 men’s experience, and from the Swedish study into the success of the new Stockholm3 trial, indicated that the evidence is moving faster than the committee is moving. I am delighted that the Government have committed to a living model. Will the Minister commit to publishing the workflow perhaps by January, so that we know when the model will be updated with the new evidence and what the workstreams are for that, particularly on the new survival assumptions and costs? Will she also open up the model, as National Institute for Health and Care Excellence does, to independent experts, because then we can have real scrutiny and debate the assumptions.

[Dr Andrew Murrison (in the Chair)]

Order. I call Alistair Strathern.

[Alistair Strathern]

I intervened.

[Dr Andrew Murrison (in the Chair)]

All right. I call Peter Prinsley.

16:52

[Dr Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

Thank you for chairing this debate, Dr Murrison. I declare an interest in that I am a surgeon and appointed chair of the all-party parliamentary group on prostate cancer.

Prostate cancer bewilders people. They think, “Surely it must be like other cancers we know about? Find it early, treat it early and save lives.” Only lung cancer causes more death in men, but prostate cancer is not so simple. We know it to be a range of diseases that behave quite differently. At the one end is the dreadful spreading disease of cancer that kills men, sometimes quickly and sometimes very young, and at the other end are the indolent cancers that simply sit around causing little trouble, so that the patient lives with the cancer and dies of something unrelated. The great dilemma is how to distinguish which is which. If we identify cancers that are, in fact, not going to cause any trouble and we treat them, we will need to deal with the consequences of the treatments and side effects that so many men fear—incontinence and impotence—and we risk doing more harm than good. That, in simple terms, explains why the screening experts have determined that at present whole-population screening is not the way to go. People find that a little difficult to understand, and so do I, to be honest.

As we have heard, at least two former prime Ministers have been advocating for screening, as have a number of famous sportsmen. The blood test used in screening is the PSA test. What is the problem? False positives—three quarters of men with PSA greater than 4 ng/ml will on biopsy be found not to have cancer—and false negatives, as men with cancer can have normal PSA. So it is not a yes or no test, and is perhaps not massively useful. The UK National Screening Committee says we should do targeted screening of men with the BRCA2 gene and a family history of prostate cancer, but it might be best to use MRI for those men.

I would like to say that there is hope. Analysis of surgical samples of prostate cancer subjected to genetic study at the University of East Anglia, where I too lately completed an MD in medical genetics studies, will soon allow us to distinguish between bad prostate cancer and good prostate cancer. We can be proud of how British science is contributing. I urge our Government to use this Parliament to support that research and those amazing scientists in their bold endeavour.

16:54

[Victoria Collins (Harpenden and Berkhamsted) (LD)]

It is a pleasure to serve under your chairmanship, Dr Murrison.

I appreciate this important debate, because for me this issue is personal. Last Christmas was particularly difficult for us as a family, because my dad had a looming prostate cancer diagnosis. He had been participating in the trial screening programme over the last 15 years, and although that is not always easy—other Members have alluded to how difficult it is—once confirmed, his early diagnosis meant that they caught it and it can be managed. Thankfully, dad is doing well.

One of my constituents, Michael from Harpenden, wrote to me ahead of today’s debate. Although he had no symptoms, he was encouraged to ask his GP for a full blood test, which found early stage prostate cancer. He tells me that under the new screening rules, he would not have been diagnosed. He calls himself one of the lucky ones, but no man’s survival should come down to luck.

As has been highlighted, prostate cancer is now one of the UK’s most common cancers, and I applaud the survivors, bereaved families and campaigners who have secured a screening programme, but that will only reach about 1,500 men, leaving out many black men and men with a family history of prostate cancer, so it must be just a first step. There are still too many men outside the programme, so I ask the Minister: learning from the stories of my dad, Michael and so many more, how do we ensure that those who need it get the screening they deserve? How can we learn from trial programmes and use new technology to make sure that it is a better screening programme for everyone involved? Will the Government urgently guarantee delivery of the targeted programme across the country and build the infrastructure to broaden screening at every possible level where it is needed? Will they look at writing into law that every cancer patient starts treatment within 62 days? Every man deserves the chance that my dad and Michael had.

16:56

[Mr Bayo Alaba (Southend East and Rochford) (Ind)]

It is a pleasure to serve under your chairmanship, Dr Murrison. I thank the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for securing this important debate.

Each year, 63,000 men are diagnosed with prostate cancer in the UK and, devastatingly, more than 12,000 will die from the disease. That is why I welcome England’s first screening programme, and why we must move at pace to put it into action. We know that while lung cancer screening was recommended in 2022, that has still not been fully implemented. For this programme to make a real difference to health outcomes, we must move quickly on implementation and, more important, ensure that it reaches the men it is designed for. Roughly 30,000 men in the UK carry the BRCA variant, but the vast majority are not aware of it.

Those at the highest risk—black men—have historically been underinformed. Black men face double the risk of being diagnosed with prostate cancer compared with their non-black counterparts, yet only 20% are aware of that. As such, black men are often diagnosed at a far later stage, when their cancer has become more difficult to treat and their chances of survival are considerably lower. In my role as a trustee of the black cancer care charity From Me to You, I have witnessed the devastating consequences of late-stage diagnosis and the power of early intervention within the community. I would like to ask the Minister: what steps is the Department taking to help the NHS find men who are unaware of the higher risk they face, either because of their ethnicity or because they carry the BRCA2 variant?

16:58

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

Many in this House will know my previous position, but I will use my speech to talk about things I understand and things I do not.

I understand why there is such a drive to pick up the screening programme. The numbers have been stated explicitly, and I understand why the Government are citing the evidence from the committee to make sure that this is measured. If there is a test that says someone may have cancer 75% of the time but does not pick it up 15% of the time, that is a matter of concern, especially when we read the statistics about 12 men in 1,000 tested being overtreated. Nobody has talked about what being overtreated means; it means a man who is perhaps 56 and asymptomatic suddenly suffering erectile dysfunction, though he never had a cancer that needed treatment. These are important points, and it is right that we expand the trial to understand more about what is going on.

Here is what I do not understand, which I will put to the Minister. The guidance for GPs has changed: formerly, when a man who was asymptomatic and over 50 requested a PSA, they could get it. We have a test that is not very good, and it is hard enough to get men in to see a doctor, but what are they most concerned about? Cancer. I have had those conversations; they understand the risks and still want that test. Why have the Government changed that, when their own consultation says:

“There was no simple way of knowing from the data whether a PSA test had been done because of a patient’s request for one, a GP’s concern about a patient’s symptoms, as part of post-cancer treatment follow-up, or active surveillance”?

The Government do not even know why PSA test access was changed. That is important. If a man goes in to ask for a PSA test, given everything he knows, he should have the right to that test until we get further information to tell him otherwise, because if I was that GP, I would be worried he would ask for my General Medical Council number and my name.

[Dr Andrew Murrison (in the Chair)]

I thank Members for their timekeeping and call Perran Moon.

17:00

[Perran Moon (Camborne and Redruth) (Ind)]

Meur ras, Dr Murrison. It is a pleasure to serve under your chairship. I thank the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for introducing the debate, and thank the 232 constituents of Camborne, Redruth and Hayle who signed the petition.

A constituent of mine, Mike from Tolvaddon, was having a blood test for an unrelated condition when a nurse suggested adding a PSA. It detected an aggressive cancer that was fortunately treatable. That was unfortunately not the case for the husband of Jean from Tehidy Park, whose cancer was not diagnosed until it had already spread to his bones. Had he had testing, he might have been here today.

I warmly welcome the Government’s actions to establish, from 2027, the country’s first targeted prostate cancer screening programme and I welcome the £18 million investment in the Transform trial. Statistics often show that men in deprived communities have a lower prostate cancer prevalence than average, not necessarily because they do not have it but because deprivation reduces their access to testing, leaving them undiagnosed. I worry that will be the case for several of my constituents, given that we suffer some of the deepest deprivation in the country.

[Dr Al Pinkerton (Surrey Heath) (LD)]

Prostate Cancer UK has identified that men from deprived areas are 29% more likely to be diagnosed with prostate cancer only at a point after the cancer has already spread, which touches exactly on the point that the hon. Member is making. Does he agree that as well as having more sensitive diagnostic tests, we must make sure that the people who are most at risk can access those tests?

[Perran Moon]

I wholly agree: efforts must focus on those areas with high levels of deprivation, wherever they are. I urge Ministers to keep further targeted expansion of screening under active review and to act as swiftly as possible as the evidence develops.

17:02

[Ben Obese-Jecty (Huntingdon) (Con)]

It is a pleasure to serve under your chairship, Dr Murrison. I declare my interest as an officer of the APPG for prostate cancer. Prostate cancer is a subject close to my heart: we all know that it affects black men, middle-aged men and men with a family history of it, and I tick all those boxes.

My father has prostate cancer and is undergoing treatment. I thank all the staff at Kingston hospital for their swift treatment of him, given he was under active surveillance. That is an important point: he got a PSA test, discovered that he had prostate cancer and as a result was placed on active surveillance because he was below the threshold required for treatment. When that active surveillance proved that he needed to be treated, staff were able to act quickly. That has, fundamentally, saved his life. He would not be eligible for the Transform trial, which will now include black men, until 2028. Who knows how far the cancer might have progressed by that point?

I take my health quite seriously and get a PSA test annually. I got my last PSA test last month and thankfully all is okay for me, but regular testing means I can keep track of it and pay attention to it. It is obvious that we need to encourage more men to get themselves tested. There are a lot of middle-aged men in this Chamber and I suspect that not everybody has had a PSA test, or had one recently.

In August, the Department of Health and Social Care withdrew the prostate cancer risk management programme after 24 years. PCRMP provided a dedicated framework for the informed choice model for PSA testing among asymptomatic men. New guidance removes references to men over 50 being considered to be at increased risk. Now that the guidance underpinning the framework has been withdrawn, will the Minister clarify how requests for testing for asymptomatic men will be handled in practice? I would be grateful if she would also clarify the Government’s official position, stated last week at Health parliamentary questions. I would also appreciate her confirmation that should men suspect that they have symptoms they can go to their GP and seek a PSA test for prostate cancer.

17:04

[Matt Western (Warwick and Leamington) (Lab)]

I thank all my constituents who signed the petition. I start by paying tribute to my constituent, Graham Fulford, for the phenomenal work that his charitable trust has done to promote awareness and improve testing across the United Kingdom. Since 2004, it has been running tests, delivering more than 470,000 and finding around 4,000 cancers. The trust estimates that that has collectively added more than 32,000 years of life.

Prostate cancer is the most common kind of cancer among men, with around 12,000 dying from it every year. As we have heard, black men are more than twice as likely to die from cancer as white men.

My request to the Minister for wider and more expansive targeted screening will come as no surprise. Last week, having had a conversation with Graham Fulford and his trust to see if they would be willing to provide support, I wrote to Mr Speaker, encouraging him to consider an annual screening programme here in Parliament to raise awareness of that need. Minister, the trust would be delighted to run it, if that is of interest.

Finally, I wish to mention my constituent, Nigel Higgins, who lost his life to prostate cancer last year. Nigel was a friend of mine and was known to many in Warwick and Leamington. I promised him I would continue his campaign in his memory.

17:06

[David Chadwick (Brecon, Radnor and Cwm Tawe) (LD)]

It is an honour to serve under your chairmanship, Dr Murrison. I am here today to speak on behalf of the 217 people in my constituency who have signed this petition, as well as those who have taken the time to write to me and those I met from Breconshire Friends of Prostate Cymru.

Today I want to share the experience of one constituent, Mr Peter Morris from Brecon, who contacted me following his own devastating diagnosis. At the age of just 56, Mr Morris was diagnosed with stage 4 prostate cancer entirely by chance after visiting his GP about an unrelated health issue. By the time his cancer was discovered, it had already spread beyond his prostate and was incurable.

Mr Morris believes that had he been offered screening at the age of 50, his cancer could have been detected before it spread, giving him a chance of curative treatment. Instead, he and his family have had to come to terms with a terminal diagnosis. I pay tribute to Mr Morris for his courage in sharing his experience and using an incredibly difficult personal situation to campaign for change that could save the lives of others.

He has expressed his deep disappointment at the UK National Screening Committee’s draft recommendations to limit screening to a very narrow group of men with specific genetic risk factors. As he rightly points out, many men will have no idea whether they carry those genetic variants, and what about men, such as Mr Morris, who have no known family history of the disease and would not qualify under the proposed criteria?

I recognise that screening is not without risks, including the potential for overdiagnosis and unnecessary treatment, but we must also recognise the real and devastating consequences of cancers being diagnosed too late.

17:08

[Dr Scott Arthur (Edinburgh South West) (Lab)]

It is a pleasure to serve under you, Dr Murrison. I start by paying tribute to the right hon. Member for Richmond and Northallerton (Rishi Sunak). He is doing a fantastic job of using the convening power that comes with his former office to shed light on this subject. The hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) did a great job of outlining the need for a more evidence-based focus on increasing the base for screening. I will not touch on that, but I do want to talk about the inequalities associated with screening.

The national prostate cancer audit in 2025 showed that inequalities in prostate cancer treatment are deepening. Men in deprived areas are more likely to present with advanced diseases and are more likely to die. That should shame us. There is a national dynamic to this. At a recent meeting with Prostate Cancer Research, I was told about the discrepancies in late diagnosis across the UK. In Scotland, 31% of prostate cancers are diagnosed too late for curative treatment. That is higher than in any other part of the UK. In London, for example, the figure is 15%. Those differences are unacceptable and should shame us.

The current system relies too often on chance and on a patient being persistent. GP guidelines do not encourage practitioners to discuss risks with patients if they are asymptomatic. That means that too many men request a test only because of a chance conversation with friends or family—or, hopefully, they might get the opportunity to access one in Parliament. Awareness of the risks is also unequal, with the most health-literate and affluent men more likely to request a test. If men from all walks of life are not aware of the risks or their right to request a test, without a national screening programme inequality is baked into the system.

[Shockat Adam (Leicester South) (Ind)]

In my constituency of Leicester South, nearly 10% of residents are from the black and Afro-Caribbean community, which is more than double the national average. Does the hon. Member agree that leaving those men in a situation where they have to know that they have to ask for a PSA test builds inequality into our system?

[Dr Arthur]

I agree and we have to be honest that this is not an issue unique to prostate cancer. With so many cancers, members of the black and ethnic minority community are much more likely to be diagnosed in accident and emergency, and that never leads to a good outcome.

Screening will not end deaths from prostate cancer completely, but it is the right way forward to minimise deaths from prostate cancer, and I think that that is something we are all agreed on today.

17:10

[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

Thank you for your chairmanship today, Dr Murrison.

In passing, I thank the Government for changing their mind about the Health Services Safety Investigation Body and for keeping that body, so that it can continue working as it is. I wonder what it would make of a systemic study of the safety management risks and how they are being managed with prostate cancer and screening, because I see very different experiences across different European countries and a wide variety of methods of gathering data. Blanket screening exists in very few countries.

I heard what the hon. Member for Bury St Edmunds and Stowmarket (Dr Prinsley) said, but my understanding is that an MRI scan followed by a needle biopsy need not necessarily have much in the way of adverse health effects. I had three MRI scans, but no needle biopsy.

[Dr Prinsley]

The problem is that that is not the screening test—the screening test is the PSA, which, as we have said, is unreliable.

[Sir Bernard Jenkin]

Many tests for initial diagnosis of many conditions are unreliable. The problem is that the Government are telling people, “You cannot have a PSA test”, unless, of course, they buy a testing kit from some fly-by-night internet company. There is a lot of that going on, which is clogging up the health system.

If someone has a doubt about what is happening down there, it should be possible—indeed, it should be encouraged by GPs—for them to have a PSA test as a precaution. If the result is a false positive, let us find out that it is a false positive. That is a much cheaper option. I mean, look at the number of deaths. Each year, 64,000 men are diagnosed with prostate cancer and there are 12,000 deaths from it. This is a very serious health situation and we should not be tolerating it.

What I see in the system is an excess of caution. Okay, we now have this Transform trial, but its effect will be to put off any further decisions until 2027. Why are we doing that? There is plenty of data and plenty of experience for the Government to make more flexible decisions.

One always wonders whether the committees that make these decisions are really independent or whether they are under pressure to control costs, because, of course, if there are more PSA tests, there is a need for more people to scan and to biopsy, and there will be more false positives to deal with, and all of that has a cost. Cost alone should not be the metric; that is not how safety is run in other industries.

There needs to be information, and a balanced and independent diagnosis of whether the system is generating the right data. Based on the evidence we already have, we are not testing enough people and we are not doing enough MRI scans. We should be doing much more.

17:13

[Sureena Brackenridge (Wolverhampton North East) (Lab)]

It is a pleasure to serve under your chairmanship, Dr Murrison.

I start by offering my thoughts to all those in Wolverhampton North East and beyond who have lost loved ones to prostate cancer or who are themselves living with it, and their families. We owe it to them and to the men still at risk to do more to find this disease earlier. Finding prostate cancer early can save lives.

In Wolverhampton North East, more than one in five of those men were diagnosed at a late stage, when their cancer was harder to treat or even incurable. That is why I welcome England’s first targeted prostate cancer screening programme, but we must ensure that it is rolled out promptly and that we move to target all high-risk men, in order to reach those who need it most.

I am particularly concerned about the data that shows that one in four black men will develop the disease, while men whose father or brother have already had it are about two and a half times more likely to develop it than other men. That is why I was proud to support the launch of the Saving Black Men’s Lives manifesto at Molineux, led by Prostate Cancer UK and the West Midlands Cancer Alliance. Brothers Reaching Out for Support and its founder, Junior Hemans, as well as lots of campaigners and patient advocates, shared their devastating experiences.

Since then, the Government have announced around £20 million for prostate cancer research and treatment, including plans to expand the Transform research trial. Will the Minister set out a clear timetable for the screening programme, explain how eligible men will be identified and outline what more is being done to raise awareness among higher risk groups and help GPs discuss risk proactively?

17:15

[Rebecca Smith (South West Devon) (Con)]

It is a pleasure to serve under your chairship, Dr Murrison. Some 310 of my constituents signed the petition, placing South West Devon eighth out of all constituencies in the country. One constituent said:

“At 73 I have lost many friends, at least 8, to this disease—and I have a few, three I know of, who were treated and survived due to early diagnosis.”

Tina wrote:

“Prostate cancer screening saved my brother-in-law; he went to the doctor for depression and was offered a routine Prostate screening test, it saved his life thankfully.”

Another constituent asked me how it is possible to have reached the age of 69 without having had a PSA check from the GP, and that person was no one other than my predecessor, Sir Gary Streeter. When he was feeling unwell for a while, he went to be tested and had a PSA of 251. He has benefited from the NHS gym scheme and specifically wanted me to ask the Minister this: what work will happen to ensure that the scheme happens right across the country, and is not a postcode lottery? He is aware that, although he has benefited from the scheme, not everybody can. Ultimately, he is doing well—just to reassure everyone.

Finally, I want to mention the Chestnut Appeal for Men’s Health, which is a local charity that works with men who are suffering from or living with prostate cancer and their families. It has done some fantastic work with Plymouth Argyle recently.

17:16

[Chris Kane (Stirling and Strathallan) (Lab)]

I want to talk about what happens after a diagnosis. A relative of mine was diagnosed with prostate cancer, and he was offered treatment through NHS Scotland. However, there was another option, focal therapy, which was not mentioned to him. He subsequently discovered that he was eligible for that treatment, but it was not available through his local health board; it was only available to him privately.

The way in which he discovered the therapy was rather unusual: he was watching “Clarkson’s Farm”. He was struck by how quickly Jeremy Clarkson appeared to have received treatment after sharing his cancer diagnosis on the programme and, given what my relative knew about both treatment and tractor suspension, how quickly he was back driving in his fields. My relative had expected that treatment would mean weeks or months of recovery, but what he saw on television prompted him to investigate, and that is how he discovered focal therapy. He eventually had the procedure and is now cancer-free, but it raises some difficult questions.

First, why was he not told about the option in the first place? As a Scottish MP, I recognise that health is devolved, but we are still part of one United Kingdom. If one part of a country is at the vanguard of new medical technology, surely we have an obligation to learn from it and share that knowledge. Whatever political or administrative boundaries we operate within, patients deserve access to information about all clinically appropriate treatment options. I am not arguing that focal therapy is suitable for every man with prostate cancer—of course, it is not. However, the availability of treatment in one part of the country should not determine whether a patient in another part even knows whether it exists, let alone whether they can access it. Surely we cannot be relying on someone watching “Clarkson’s Farm” to push for information on what their treatment options might be.

I ask the Minister: what more can be done to ensure that patients across all four nations of the United Kingdom are informed about clinically appropriate treatments, including those available beyond their own health board and national NHS system? Screening would give more men information quicker to start to make informed decisions with their doctors. However they find their way to the doctor to take a PSA test, if they are fortunate enough to find out early that they have cancer, we owe them all the information they need to make informed choices about what happens next.

17:18

[Ian Sollom (St Neots and Mid Cambridgeshire) (LD)]

It is a pleasure to serve under your chairmanship today, Dr Murrison. I am particularly proud to have my constituent Dave Young in the Gallery today. Dave was diagnosed with prostate cancer without symptoms in 2024, following a PSA test, and he has since dedicated himself to helping other men catch theirs early. Around 350 men have been directly tested through his campaigning in and around St Neots, and at an event in September, 122 men were seen in a single day. Of the six investigated afterwards, four have had cancer confirmed, so I thank Dave.

The best tribute that we can pay to Dave and other campaigners like him is to get the policy right. I challenge the Minister on whether the National Screening Committee’s modelling back in May actually did that. The committee judged screening against a threshold of £20,000 per quality-adjusted life year, but since April, NICE can approve a medicine for advanced prostate cancer at up to £35,000. Analysis commissioned by Prostate Cancer Research showed that treating a man diagnosed at stage 4 costs roughly 10 times as much as stage 1, so the NHS will pay more to treat this cancer once it is incurable than it is prepared to pay to find it earlier. That does not seem consistent.

The case against wider screening rests on harms, overdiagnosis and unnecessary treatment. I will not repeat what Members have said on the statistics for that, but I would like to ask whether the screening was judged as the NHS would actually deliver it today, with MRI scans, or as it was delivered 20 years ago. Can the Minister publish the model on terms equivalent to NICE, so that independent experts can test it and give a dated timetable for reconsidering the decision? Dave and other men campaigning on the issue would very much appreciate that.

17:20

[Alex Ballinger (Halesowen) (Lab)]

It is a pleasure to serve under your chairship, Dr Murrison. I will begin with testimony from two constituents. Angela Duffill lost her dad to prostate cancer in 2019. She speaks warmly of the 20 years of NHS care he received at Russells Hall hospital, but she also writes of the time before his diagnosis, when he was sitting on his symptoms and suffering in silence, not knowing what was wrong and not going to the doctor to find out. The familiar mix of embarrassment, stoicism and a public-spirited reluctance to waste NHS time is all too common among men of his age. Angela wonders whether a comprehensive, better publicised screening programme would have encouraged her dad to seek help sooner.

Another constituent, Mervyn Jackson, wrote to me with his story. As prostate cancer ran in his family, he was encouraged to have regular tests. In 2021, those tests detected the cancer while he was still at an early stage. Mervyn said:

“The worrying thing is that I had no symptoms at all from the cancer.”

At the time of diagnosis, he felt completely well. There was nothing to tell him that he needed treatment, and nothing to prompt him to get tested, which he would not have done had it not been recommended based on his congenital risk. Following a successful round of radiotherapy, Mervyn is now 78 and in good health, living a full and active life.

When we discuss early diagnosis, that is the possibility we are talking about—finding cancer while there is still time to treat it, potentially giving someone decades more of life. I welcome the Government’s decision to introduce targeted screening for men with the BRCA2 gene and a relevant family history of cancer, but many families will still be left asking where current policies leave them. I hope the Minister will recognise the urgency behind these concerns, and the need to keep wider screening under review and give families clear guidance while that work continues.

17:22

[Paul Davies (Colne Valley) (Lab)]

It is a pleasure to serve under your chairmanship, Dr Murrison. The National Screening Committee’s current recommendations are very restricted, limiting prostate cancer screening to every two years for men aged between 45 and 61 with pathogenic BRCA2 variant and a family history of breast, ovarian, pancreatic or prostate cancer. According to its modelling report, just one in 277 people has the variant. In total, around 1,500 men in England would be eligible for such screening.

The Transform trial is a key part of the Government’s strategy for improving detection and support for men with prostate cancer. It is a long-term commitment and I absolutely support that work, but I am concerned about the lack of strategy to support men with, and at high risk of, prostate cancer in the interim. Clearly, this impacts men today. I am concerned that the decision to withdraw the previous prostate cancer risk management programme and to direct GPs to refer to guidance in NICE clinical knowledge summaries when discussing PSA tests with patients has seriously reduced clarity for patients.

[Luke Murphy (Basingstoke) (Lab)]

I have met many men and their families in Basingstoke who have been affected by prostate cancer. Although many of them welcome the targeted screening programme, we need reassurance from the Government. As more evidence comes to light from the fantastic Transform programme, does my hon. Friend agree that the Government should commit to expanding it as the evidence allows?

[Paul Davies]

I absolutely agree. We clearly have to act on that, and very quickly—that is the key point that many Members have made. We cannot wait. We see so many men affected by this illness and, unfortunately, many deaths and many men suffering for a long period.

[Claire Young (Thornbury and Yate) (LD)]

On the hon. Member’s point about lack of clarity, my constituent Richard went to his GP with early symptoms of prostate cancer, but because he did not fit the screening profile his GP refused a PSA test. Does the hon. Member agree that Ministers could issue guidance to make sure that GPs are not misinterpreting the new situation?

[Paul Davies]

I absolutely agree. I recently had to work quite hard to get a PSA test. I have a very good GP, but was basically told it was a waste of time having the test. We need to make sure we have clarity so that GPs know how to deal with this and men understand that they have an entitlement to the test.

I ask the Minister to make sure that we have a clear offer to higher-risk men. Will she confirm that men aged 50 or over or at higher risk are able to discuss the pros and cons of testing with their GP, and that the entitlement to a PSA test remains even though the PCRMP has been withdrawn? Going back to the screening we have at the moment, will she explain how BRCA2 carriers will be found and invited to screening going forward?

17:27

[Sarah Hall (Warrington South) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Dr Murrison. In 2017, my constituent Tony Collier was training for an ultramarathon. Tony was 60, fit and otherwise well. He was the kind of man who rarely sat still long enough to think about his own health. He thought he had a groin injury from his training. He went to the doctor and was diagnosed with advanced prostate cancer. He was told that his cancer had been developing for around 10 years. In that moment, Tony’s life changed forever. Tony did not ignore symptoms; there were not any until it was too late.

I met Tony through his dedicated campaigning for earlier diagnosis. Along with another of my constituents, Paul, he set up the Warrington Area Prostate Cancer Alliance to support other men from Warrington living with prostate cancer. Tony is working with national cancer organisations to make the case for change so that more men like him and those at high risk can get this lifesaving test. Tony believes that if he had had regular PSA tests from the age of 50, there is a good chance he would have been diagnosed earlier, when his cancer was still curable. Tony does not campaign for sympathy; he campaigns so that other men do not have to rely on chance to find out that they have cancer.

I hope the Minister listens to Tony’s story and acts on the recommendations from Prostate Cancer Research, including by publishing a timetable for reviewing screening evidence by January 2027 and providing six-monthly updates on the model and clear decision points for black men, tied to stage one of Transform; by funding new research into who currently receives PSA tests, why and with what outcomes; by allowing independent experts to scrutinise the UK National Screening Committee’s model on terms equivalent to NICE; by publishing a protocol for confidential and emerging evidence applied consistently to every test and trial; and by confirming that a man aged 50 or over or at higher risk who has discussed the pros and cons with his GP remains entitled to a PSA test now that the PCRMP has been withdrawn.

[Dr Andrew Murrison (in the Chair)]

Well done, everyone; we got all the Back Benchers in.

17:27

[Helen Maguire (Epsom and Ewell) (LD)]

It is a pleasure to serve under your chairmanship, Dr Murrison. I thank the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for securing this important debate.

Prostate cancer is now the most commonly diagnosed cancer in men in the UK. Around 540,000 men are living with or after prostate cancer. Each year, more than 64,000 men are diagnosed and over 12,000 will die from prostate cancer. One man dies of prostate cancer every 45 minutes—two lives will be lost in the short time of this debate.

The estimated lifetime risk is one in eight for men overall, but that rises to one in four for black men. In England, black men are also twice as likely to die from prostate cancer as white men, with a lifetime risk of one in 12 compared with one in 24. Like with all cancers, the earlier the stage at diagnosis, the better the chances of survival: five-year survival rates are almost 100% at stages 1 and 2, around 95% at stage 3 and around 50% at stage 4.

Who is diagnosed late also follows a pattern. In England, men in the most deprived areas have an 11% higher chance of a metastatic diagnosis. Men in the most deprived areas also have a 19% lower chance of receiving a prostate cancer diagnosis than men in the least deprived areas. Prostate cancer mortality rates in England mirror that diagnosis trend. Mortality rates are 14% higher for men in the most deprived areas than for men in the least deprived areas, and around 740 deaths from prostate cancer each year are linked with deprivation.

Incidence rates of prostate cancer have risen by 54% since the early 1990s and are projected to rise a further 14% by 2038-40. That means around 85,100 new cases of prostate cancer each year. Part of the rise in diagnoses reflects much greater awareness, with more men coming forward for PSA tests. The issue of prostate cancer screening could not be more important.

The Liberal Democrats applaud the tireless hard work of all cancer survivors, bereaved families and campaigners in securing a screening programme. However, we must do more to fight this devastating disease, and that is something the Liberal Democrats have continuously campaigned on. The Liberal Democrats are proud that our campaigning played a role in driving the Government to take action on this issue and ultimately deliver a prostate cancer screening programme. The programme will save thousands of lives, and it is unacceptable that no screening programme existed previously.

Screening programmes are standard across a range of cancers, but until recently there was no screening programme for prostate cancer at all—there is now only a targeted programme. The Government must urgently guarantee the delivery of the targeted screening programme across the country. That will lay the foundations and establish the infrastructure needed to further broaden screening as soon as possible. The Government must make improved testing for prostate cancer a priority; it is fundamental to saving lives. The Liberal Democrats will hold them to account on delivering better testing and ensuring that more men can be protected from this devastating illness.

The issue of prostate cancer testing has been handled, in many instances, very insensitively. Alongside the announcement of the screening programme, the NHS quietly tried to change the rules around a man’s right to request a PSA blood test. That is not right. It is shocking that it then told campaigners and NHS staff that that had been the case all along. It is simply not good enough.

Patients and their families deserve honesty and transparency. Is it really the Minister’s position that we should change years of standard practice and prevent men from making an informed choice to request a test? What has changed in the past few months to cause such a backward step in access? Was there any new evidence that informed the decision?

Improved screening must go hand in hand with faster treatment and a guarantee: it must be written into law and backed by investment that every patient, including those with prostate cancer, is treated within 62 days. The Liberal Democrats recognise that speed and quality of treatment are central to increasing survival rates of prostate cancer. To achieve that, we would introduce a guarantee that 100% of patients will be able to start treatment within 62 days from urgent referral, and we would replace ageing radiotherapy machines and increase their number so that no one has to travel too far for treatment. Liberal Democrat research last year found that eight in 10 hospitals are using outdated medical equipment, such as MRI scanners. Those machines are essential to fully diagnosing prostate cancer.

We would recruit more cancer nurses so that every patient has a dedicated specialist supporting them throughout their treatment. We would expand the Medicines and Healthcare products Regulatory Agency’s capacity in order to halve the time for new treatments to reach patients. The Liberal Democrats also want to make the UK a world leader in cancer research, and we are calling for a cancer survival research Act. That would require the Government to co-ordinate and ensure funding for research into cancers with the lowest survival rates, including brain cancer.

We would also start a fellowship programme for US cancer scientists who have seen their funding slashed by President Trump. That would waive the burdensome fees and bureaucracy for international researchers on the whole. Global talent visas for top researchers currently cost £6,000 per person for a five-year visa—that is £18,000 for a family of three. That is significantly more expensive than most of our competitor countries, where a similar visa is typically £200 or £300 per person. The cost of visas for Cancer Research UK alone is £900,000 a year, which is the equivalent of setting up two new research labs every year.

The fellowship scheme would also deliver more funding for salary and research costs for researchers by expanding the share of GDP being spent on research and development to 3.5%. That would unlock hundreds of millions of pounds per year for cancer research and billions more for our life sciences sector generally. We would deliver that through a decade-long programme of public investment into R&D.

I therefore urge the Minister to reflect on all the contributions and the calls made by me and my colleagues for the 540,000 men who live with or after prostate cancer, for their loved ones, and for the two men who will have lost their lives to prostate cancer in the short 90 minutes of this debate.

17:35

[Gregory Stafford (Farnham and Bordon) (Con)]

It is a pleasure to serve under your chairmanship, Dr Murrison. I congratulate my hon. Friend the Member for Berwickshire, Roxburgh and Selkirk (John Lamont) on securing the debate and speaking on behalf of the Petitions Committee. I thank all Members who have spoken powerfully and in a considered manner, whichever side of the argument they are on, and the 100,000-plus people who signed the petition, including the 198 from my constituency. My thoughts go out to all those in my constituency and across the country who are affected by this terrible illness.

In November 2024, I supported Cancer Testing South—run by one of my constituents—at a free screening event in Bordon. I took a PSA test myself. It was quick and simple, and it gave me peace of mind. It showed how important it is to make testing accessible and to reach men who might never otherwise consider it.

[Rebecca Smith]

Will my hon. Friend join me in congratulating Plymouth Argyle football club on its commitment to work with the Chestnut Appeal by running community diagnostic events annually before football matches?

[Gregory Stafford]

I thank my hon. Friend for the work of her constituents in that important area. I must also recognise the previous Government’s work, particularly that of my right hon. Friend the Member for Richmond and Northallerton (Rishi Sunak)—whose commitment has continued beyond his time in office, as we have seen today—and that of my noble Friend Lord Cameron of Chipping Norton and my right hon. Friend the Member for Braintree (Sir James Cleverly). With Prostate Cancer UK, we as the Conservative Government committed £42 million to launch Transform, the largest prostate cancer screening trial in the world.

I welcome some of what the current Government have done, but important questions remain about access to testing, identifying men at highest risk and how evidence will translate into policy. First, on PSA testing guidance, as raised by my hon. Friends the Members for Hinckley and Bosworth (Dr Evans) and for Huntingdon (Ben Obese-Jecty), the guidance setting out the right of men over 50 to request a PSA test was withdrawn earlier this year. The Government say that policy has not changed and attribute the concerns to “misinformed media coverage”, yet a written answer in September confirmed that no impact assessment was undertaken because there was

“no change in policy to assess.”

If the policy had not changed, why was the guidance withdrawn? And how was it established that the change had no impact without an assessment? On 21 October, the Government said that

“officials continue to work with NICE”,

which does not clarify whether the changes to the clinical knowledge summary were discussed. Prostate Cancer Research has asked the Department to confirm that higher-risk men can still access a PSA test once informed of its risks and benefits. As of 14 October, it has had no reply. Will the Minister confirm clearly that those men can access testing?

Secondly, on support for those at the highest risk, I of course respect the committee’s independence while it reviews the evidence, but the Government can take practical steps in the meantime. Prostate Cancer UK has called for GPs to inform black men and men with a family history of their elevated risk and to offer them a PSA test. What will the Government do to improve access for such men now, rather than leaving them to wait years for the wider review?

Thirdly, on identifying BRCA2 carriers, an estimated 13,000 men carry that variant, yet most have never been tested and do not know. The Telegraph reported that only about 1,500 men will be invited for testing next year. How will the programme reach the wider population whom it is meant to benefit? The committee’s consultation document stated:

“DHSC analysts are undertaking an exercise to estimate the cost of identifying new BRCA variant carriers.”

Has that work been completed? Will it be published? What will the Government do to identify men who carry the variant without knowing it?

Fourthly, on Transform and the NSC model, the committee will work with SCHARR—the Sheffield centre for health and related research—to update its modelling in the light of the trial’s findings, in particular for black men. It will also examine risk algorithms and biomarkers, including the Stockholm3 test, and whether family history can be more tightly defined. That work of course matters, but its impact depends on how quickly findings inform decisions and whether the public can see what is happening.

Will the Minister commit to publishing by January of next year a dated programme for updating the model, covering the biomarker review and family history work, and reporting to this House every six months? Will she set a named decision point for black men, tied to the results of Transform’s first stage so that reconsideration does not default to the next scheduled review in 2029? What evidence will trigger a change to that model, and will independent experts be given access to it on terms similar to those NICE offers for medicines so that the assumptions can be tested?

Finally, I have some questions about how the value of screening is judged. Since April, NICE has been able to approve a medicine for advanced prostate cancer at up to £35,000 per quality-adjusted life year—a threshold raised as part of the trade deal with the United States. The screening committee judged earlier detection against a figure of £20,000. Why does the NHS now appear to value treating late-stage prostate cancer more highly than preventing it? Will the committee’s forthcoming methods guide bring the two thresholds into line?

In conclusion, I recognise the committee’s concerns about the harms of population-wide PSA screening, including overdiagnosis and treatment, and the uncertainties in the evidence for black men.

[Nigel Huddleston (Droitwich and Evesham) (Con)]

We have heard several times today about the importance of making informed decisions, but we cannot make informed decisions unless we are properly informed in the first place. Therefore, while there are some valid concerns about risk, the most important duty we and the Government have is to do everything we can to raise awareness so that people can make important, informed decisions. That is our duty, and I commit to doing so on behalf of my 357 constituents who signed the petition.

[Gregory Stafford]

My hon. Friend is a great champion for his constituents, especially on this issue but on others as well. He is absolutely right that while the committee is making its evidential findings, there is nothing to stop the Government promoting a number of these ways to make sure that those at highest risk are getting treatment as soon as possible.

Cancer Research UK has highlighted the risks too. As my hon. Friend said, screening must be evidence-led, but Transform exists to address the limits of existing evidence, and improvements in testing and MRI-led pathways offer ways to improve how men are assessed, as many Members have mentioned. Uncertainty must not be the end; it must lead to research and progress, not delay.

The former shadow Health Secretary, my right hon. Friend the Member for Daventry (Stuart Andrew), set out the position of His Majesty’s Opposition last August. He said we would

“back the latest evidence and research to ensure patient care remains at the heart of testing guidance.”

That is clearly the right approach: act where the evidence supports it, accelerate research where questions remain, and be clear about when decisions will be made. Men must not be disadvantaged by circumstances beyond their control. One may have no family records because his father died young, for example; another may simply want to discuss his risk with his GP. As my right hon. Friend said, no man with potential prostate cancer symptoms should be denied a test because of poor family records.

To conclude, His Majesty’s loyal Opposition support targeted screening for men at highest risk, Transform and the committee’s evidence-led approach. But we need clear guidance from the Government on PSA testing, practical support for men at the highest risk, a credible plan to identify BRCA2 carriers and a dated timetable for the model, with independent scrutiny of it and transparency about how Transform will shape policy. I hope the Minister will address those questions directly now; if not, will she write to me and set out clearly what patients can expect next?

17:43

[The Minister for Public Health and Patient Safety (Dame Diana Johnson)]

It is a pleasure to serve under your chairship, Dr Murrison. I am grateful to the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for opening this important debate and setting out so clearly the questions he wants answered.

I want to begin by acknowledging the strength of feeling behind the petition. More than 100,000 people have signed it and a large number of right hon. and hon. Members in the Chamber have made very powerful speeches. I will reflect on the issues raised; I will try to address as many of the points in my contribution this afternoon, but if I do not answer every question, I will reflect on them and I will certainly write to the shadow Minister.

There is a very real desire for us to do more to diagnose prostate cancer effectively, treat it earlier and ultimately save more lives. I am grateful to Members from across the House who have spoken so openly about their own experiences and those of their constituents, friends and families. I too am thinking of all those individuals facing a prostate cancer diagnosis and undergoing treatment at this time, and I was very pleased to hear that our former colleague, Gary Streeter, is doing well. I am sure that the whole House sends him our best wishes.

As we have heard, prostate cancer is the most common cancer in men in the United Kingdom. Around 68,000 men are diagnosed in the UK each year, and although survival rates are high, tragically, around 12,000 men still die from prostate cancer every year. Every one of those deaths is a loss to their family, friends and community. The Government are determined to improve outcomes for men with prostate cancer.

The UK National Screening Committee advises all four nations. Scottish officials are present at committee meetings and officials in the Department of Health and Social Care work with their counterparts across the devolved Governments to share information and good practice. In June, we announced England’s first targeted prostate cancer screening programme. From 2027, eligible men aged 45 to 61 with a BRCA2 gene variant and a family history of prostate, breast, pancreatic or ovarian cancer will be offered a PSA test every two years. We are working with the UK Cancer Genetics Group to identify further men who will be eligible for screening. That is an important step forward, but I recognise that for many it does not go far enough.

The petition asks the Government to go further than the UK National Screening Committee’s recommendation and introduce screening for all men at higher risk. I understand that ambition and I share the determination behind it, but we have a responsibility to ensure that the evidence tells us that, when we introduce screening, it will do more good than harm. That balance is particularly difficult with prostate cancer, as we have heard from some of the medically qualified Members. Unlike many other cancers, prostate cancer is often slow growing, and many men who develop it will never experience symptoms or come to any harm from it.

At the same time, treatment can have profound consequences. More than half of those treated experience significant side effects, including bladder leakage, bowel incontinence and erectile dysfunction. When we talk about the harms of screening and overtreatment, we are not talking about something abstract; we are talking about potentially lasting consequences affecting a man’s health, dignity and quality of life.

[Dr Luke Evans]

Will the Minister give way on that point?

[Dame Diana Johnson]

I am going to make some progress, because I am keen to address the points that the hon. Member for Berwickshire, Roxburgh and Selkirk raised. If I have time at the end, I will take an intervention.

I want to turn to the issue of ethnic minority men. I have listened very carefully to the concerns about men at higher risk who are not included in the initial screening programme, particularly black men and men with a family history of cancer. We know that black men are twice as likely as white men to be diagnosed with prostate cancer, and that disparity rightly worries us all. What we do not yet know is whether screening black men would identify more aggressive cancers that need treatment, rather than slower growing cancers that may never cause harm. If screening leads to men being diagnosed and treated for cancers that would never have harmed them, we risk causing significant and lasting harm, and that cannot be right.

We should not accept the gaps in the evidence that prevent us from giving men the answers that they deserve. That is why the Government are investing and building on the Transform trial introduced by the previous Government by investing £34 million to identify better ways to screen for prostate cancer and enable all eligible black men to be invited to participate at stage 2. Prostate Cancer UK is working with charities and organisations experienced in working with black communities to encourage participation. That matters because we need stronger evidence built with the men most affected to inform future decisions about screening.

Family history is another important part of this picture. We know that it can increase a man’s risk, but the evidence does not yet tell us precisely which patterns of family history confer the greatest risk. Work is under way to refine the definition of family history and ensure that it is properly reflected in the UK National Screening Committee’s model. I totally accept that men need support now, which is why Cancer Research UK, the UK Cancer Genetics Group and the Royal College of General Practitioners are bringing together expertise to develop guidance to support GPs when advising men about familial risk.

[Sir Bernard Jenkin]

Will the Minister give way?

[Dame Diana Johnson]

I will carry on because I want to make these points.

The important point is that the evidence and clinical practice are evolving, and our approach must be able to evolve with them. That is why the Government are funding the prostate cancer screening model used by the UK National Screening Committee for a further three years. Work is already under way on family history, risk algorithms and biomarkers, including Stockholm3, and significant evidence from Transform can be considered as it emerges. The initial programme is therefore not the end of the process. Where robust new evidence supports screening additional high-risk groups, that evidence can be considered and screening recommendations revisited.

[John Glen (Salisbury) (Con)]

Will the Minister give way?

[Dame Diana Johnson]

I will carry on because I am conscious of time and I want to make these points.

I want to address directly the concern about the evidence underpinning the current screening recommendation. The committee considered the current NHS standard of care, which includes the use of MRI before biopsy. It did not include newer and innovative approaches for which the evidence is not yet sufficiently established. There are enormously encouraging advances taking place, including more targeted approaches, such as focal therapy. Better diagnosis and less harmful treatments could change the balance between the benefits and harms of screening, and as robust evidence develops, it will be considered.

I also want to deal with the point about GPs. I have heard the strength of feeling about PSA testing for men who are not eligible for the new screening programme. I want to reassure men that the policy has not changed. Any man who is concerned about prostate cancer, including a man without symptoms, can discuss PSA testing with his GP. Separate from the decision on national screening programmes, it is my view and the Secretary of State’s view that men who ask their GP or urologist about a PSA test should be able to make an informed choice, based on good-quality information, about the likelihood of being helped or being harmed. The Secretary of State worked on this issue as a Health Minister at the Department almost 25 years ago, and personally ensured that the guidance includes references to the importance of informed choice.

[Dr Luke Evans]

Is the Minister therefore saying that a 52-year-old patient who understands the risks on both sides and wants their PSA has the right to get it, or is it the GP’s decision? The GP could deny it on a clinical basis even if the patient wants it. That is the change that people are worried about. Could she explain that point?

[Dame Diana Johnson]

I recognise the hon. Gentleman’s experience as a GP. My understanding is that a man who requests a PSA test from a GP will have that test if he is given the information and the choice is there, but I will write to the hon. Gentleman if that is not correct. It has to be an informed choice, with the man knowing the risks and the harms but also the potential benefits.

Ultimately, everyone in this Chamber wants the same thing: we want fewer men to die from prostate cancer, cancers that need treatment to be found earlier, and every man to receive the care that is right for him; but we must achieve that while protecting men from unnecessary diagnosis and from receiving treatments that can have lifelong consequences for a cancer that might never have caused harm. The question is not whether we want to prevent more deaths from prostate cancer—of course we do. The question is how we can do so safely, effectively and fairly, using the best available evidence while continuing to build the evidence where it is not yet strong enough. As I have said, as that evidence develops, we must be prepared to act. I thank the hon. Member for Berwickshire, Roxburgh and Selkirk for raising this important issue, and all Members who have contributed to this thoughtful and powerful debate.

17:56

[John Lamont]

I thank David James, the petition creator, and Prostate Cancer Research for leading the campaign so effectively. That so many colleagues decided to contribute to this debate is a sign of its success. I thank all colleagues, who spoke passionately, albeit briefly, about the importance of the issue. Some shared very moving experiences, either personal or on behalf of their constituents.

I thank the Minister for her response. It is important to have reassurance from the Government that they will be led by the evidence. The Minister said that she will consider further evidence that emerges from the research, but it is important that the Government do more than consider the evidence; they must be led by it.

[Rishi Sunak]

I too thank the Minister for her considered response. As she can see from the attendance for this debate, there is enormous interest in the timetable for updating the model with new evidence, some of which has been published already. Does my hon. Friend agree that time is of the essence, and that we would appreciate some clarity on timelines?

[John Lamont]

My right hon. Friend is absolutely right. It is important that the people involved in the campaign and those trying to ensure that men are saved from this terrible disease have some certainty. If the Minister wrote to me with a timetable for when the Government expect to respond and deal with the issue, I could share that with colleagues who participated in this debate. Last, I thank the team at Transform. They do tremendous and inspiring work, and, ultimately, they will save the lives of more men.

Question put and agreed to.

Resolved,

That this House has considered e-petition 751472 relating to prostate cancer screening.