BRCA genes and prostate cancer: what the screening decision means for men

Men who have a higher risk of prostate cancer due to variations in their BRCA genes should be invited for routine screening – to give them the best chance of finding the disease early, when it’s easier to treat. 

That’s the verdict of the National Screening Committee, following its latest evidence review. It’s a small but significant step forward on our path to a screening programme for all men. 

But what are these genetic variations? How can you find out if you have them? And what steps can you take to understand your risk right now?

Our Senior Health Information Officer Sophie Steers explains everything you need to know. 

BRCA genes keep healthy cells growing normally – and at the same time, they prevent cancer cells from developing.  

We all have BRCA genes, which are passed down to us from our parents. But for a small number of people, these genes contain changes that cause them to stop working properly. When this happens, it’s known as a ‘gene variation’. 

BRCA gene variations are more commonly known to increase women's risk of getting breast or ovarian cancer. However, the latest research suggests that men who have these variations are at higher risk of getting prostate cancer too. These genetic variations may also increase a man’s risk of getting an aggressive form of the disease that spreads quickly. 

If any of your family members have had prostate cancer, breast cancer or ovarian cancer, it might have been caused by a BRCA gene variation. This is why it’s important to speak to your GP about your risk.  

Your GP will be able to discuss your risk of prostate cancer with you – and they may refer you for a spit test or a blood test to see if you’ve inherited these genetic variations from your parents. 

Only around 1 in every 300 to 400 people will have BRCA gene variations. But although it’s rare in the general population, we know that people from Ashkenazi Jewish background are more likely to have these genetic variations. In fact, as many as 1 in every 40 Ashkenazi Jewish people may carry these variations.  

In England, the NHS offers free BRCA gene testing for anyone aged 18 or over who has at least one Jewish grandparent. 

If you have BRCA gene variations, it doesn’t mean you will get prostate cancer. But it’s important to know your risk of the disease will be higher than other men.  

So it’s a good idea to speak to your GP. They can talk to you about your risk of prostate cancer and the option of having a PSA blood test to check for early warning signs. 

Worried about your risk of prostate cancer? Or have questions about the PSA blood test? If you’d like to speak to someone, we’re here to help. You can talk to one of our trained Risk Information Officers, who can answer your questions and provide support. 

Routine screening for men with these genetic variations is a step in the right direction, giving tens of thousands of men at highest risk their best chance of finding prostate cancer early – when there’s still time for a cure. 

It’s the first time the National Screening Committee has recommended prostate cancer screening of any kind in the UK – and it gives a clear signal that definitive evidence can lead to real change. 

But screening will still be out of reach for hundreds of thousands more high-risk men, including Black men and those with a family history of the disease. So we won’t stop until we have a safe, accurate and effective screening programme that invites all men for routine tests.  

That’s why we’re funding the innovative research – our £42 million TRANSFORM trial – that will lead us to a much bigger screening programme, saving thousands of lives every year. 

Without a mass screening programme, it’s important that every man knows his risk right now – so he can make an informed choice about having a PSA blood test to check for early signs of prostate cancer.  

So while we press ahead with the vital research that will help us extend screening to thousands more men, the Government must act now on early detection – to start saving lives today. 

We’re calling on ministers to change NHS guidelines immediately, to give GPs the power to have potentially lifesaving conversations with men at highest risk. We’re also urging them to fund public awareness campaigns that would help millions more men find out if they’re at risk and what to do next, while replacing confusing clinical guidance with our quick and easy online Risk Checker.