Men aged 50 and over in England will no longer be automatically entitled to a PSA blood test for prostate cancer, after officials at the Department of Health and Social Care withdrew long-standing guidance that gave them that right, according to a letter sent to health organisations this week.
For more than two decades, the prostate cancer risk management programme allowed any man over 50 to request a PSA test from their GP without needing symptoms first. Under the new approach, GPs will instead use their own clinical judgement to decide whether a test is appropriate, weighing up a patient’s individual risk factors rather than treating age alone as a trigger.
The change comes after the government decided against introducing a full national screening programme for prostate cancer, opting instead for a narrower scheme targeting men with a specific genetic risk factor, alongside a family history of the disease. That programme, covering men aged 45 to 61 who carry a particular BRCA2 gene variant, is due to begin in 2027 with testing offered every two years. Black men aged 45 to 74 will separately be invited into a research trial if they have not had a PSA test or prostate MRI in the past five years.
Campaigners and medical charities reacted with alarm. David James of Prostate Cancer Research warned that thousands more men a year could face late, incurable diagnoses as a result, and argued the policy left patients with the disadvantages of having no screening programme while also making it harder to get tested on their own initiative.
Former prime minister Lord Cameron, whose own prostate cancer was detected through a PSA test, criticised the move as a step in the wrong direction and renewed calls for a proper targeted screening programme for men at higher risk. High-profile diagnoses in recent years, including those of Olympic cyclist Sir Chris Hoy and broadcaster Jeremy Clarkson, have driven increased demand for testing among middle-aged men.
Prostate cancer remains the most common cancer among men in the UK, with roughly 63,000 new diagnoses and around 12,000 deaths each year. Unlike breast, bowel and cervical cancer, it has no national screening programme.
A Department of Health and Social Care spokesman said the underlying policy had not changed and that men would still be able to ask their GP for a PSA test, adding that the decision had always ultimately rested with GPs. The department said the earlier guidance had simply been retired for being unclear, and that the letter was intended only to point GPs and other health bodies towards updated advice. Officials also said there was no change to the separate policy covering men who present with possible symptoms of prostate cancer, who will continue to be referred for testing as before.
