Prostate Cancer Screening

Bernard Jenkin Excerpts

Monday 26th October 2026 Westminster Hall

[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.

--- Later in debate ---

[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.