Updates to the guidelines on prostate specific antigen (PSA) testing in asymptomatic men

Earlier this year, the National Screening Committee made their final recommendation for a targeted prostate cancer screening programme for men with a BRCA2 gene variant who have a family history of cancer. This recommendation was then approved by the Government.

As part of that announcement, a review of the current guidelines for diagnosing prostate cancer for asymptomatic men was confirmed. There is no change to the symptomatic pathway.

Since then, the Prostate Cancer Risk Management Programme (PCRMP), the previous clinical guidelines for diagnosing asymptomatic prostate cancer, has been withdrawn, and existing links now direct to the NHS’s prostate cancer pages. This main public-facing guidance explains what prostate cancer is, its symptoms and causes, and the next steps (tests). It has been updated to align with the current position and states that PSA blood tests are not routinely offered to men without symptoms or a BRCA2 gene variant.

If a patient is worried about prostate cancer, they can ask their GP about having a PSA test. As the healthcare professional, the GP will consider the patient’s cancer risk to help reach a judgement on whether undertaking a PSA test is the right option for the patient. They'll clearly lay out the pros and cons of taking the test to the patient.

The main guidance for GPs is the Clinical Knowledge Summary (CKS) from NICE. The development of this guidance is ongoing, and while we welcome efforts to streamline clinical guidance, it's vital that it reflects the best evidence available. Prostate Cancer UK will be working with stakeholders to help inform this work, so clinicians have clear, up-to-date information which reflects the evidence base and best practice.

For any clinicians who want to help their patients better understand their risk and their options we'd encourage you to utilise our website and online risk checker.

Our CEO Laura Kerby has written an open letter outlining our position on the recent changes. You can read this here.