Next week marks the start of Movember, the annual November campaign that puts men’s health, and prostate cancer in particular, in front of the public. This year it arrives at an unusual moment. In June the government accepted advice to create the UK’s first prostate cancer screening programme, due to begin in England in 2027, yet it will cover only around 1,500 men. At the same time, the largest prostate cancer screening trial in more than two decades has started testing its first participants, with the explicit aim of building the evidence for something much broader. Between the scale of the disease, the caution of the screening decision and the trial designed to answer the questions it left open, prostate cancer is one of the most closely watched subjects in UK health research right now.

The Most Common Cancer Without a Screening Programme

Prostate cancer is now the most commonly diagnosed cancer in the UK. According to Prostate Cancer UK, more than 56,000 men are diagnosed with it every year in England alone, and more than 12,000 men across the UK die from it annually. The UK National Screening Committee describes it as the second most common cause of cancer death in men, after lung cancer, and the most common cancer not to have a national screening programme. Risk rises steeply with age, and around 75 per cent of prostate cancer deaths are in men aged 75 and over.

The risk is not evenly shared. A study by Prostate Cancer UK and Public Health England, published in BMC Medicine in 2015 using data for more than 25 million men in England, estimated the lifetime risk of a prostate cancer diagnosis at around 1 in 8 for White men, 1 in 4 for Black men and 1 in 13 for Asian men. The lifetime risk of dying from the disease followed the same pattern, at around 1 in 24 for White men and 1 in 12 for Black men. Once diagnosed, men of all three groups were equally likely to die from the disease, which means the higher death rate among Black men is driven by how many more of them develop it in the first place.

A Programme for 1,500 Men

The UK National Screening Committee agreed a draft recommendation in November 2025, put it out to a 12 week public consultation that drew nearly 1,000 responses, and confirmed its final position at a meeting in March 2026, with the minutes published on 28 May. It recommended a targeted programme offering a prostate-specific antigen (PSA) blood test every two years to men aged 45 to 61 who carry a disease-causing BRCA2 gene variant and have a family history of breast, ovarian, pancreatic or prostate cancer. It recommended against screening the whole male population and against targeted screening of any other risk group. Health Secretary James Murray accepted the advice on 2 June, and the government has since estimated that around 1,500 men in England will be eligible when the programme rolls out in 2027.

The reasoning turns on the balance of benefit and harm. The committee concluded that screening was more likely to do more harm than good across the whole population, and for men with a family history of cancer but no BRCA2 variant, because the PSA test is not reliable enough to separate dangerous cancers from slow-growing ones that would never cause a problem. The main harms it identified were incontinence and erectile dysfunction following unnecessary biopsies or treatment. Men carrying BRCA2 variants are different because their cancers tend to arrive earlier and grow more aggressively. The final recommendation was narrower than the draft, which had also included BRCA1 carriers, after geneticists advised that the BRCA1 risk was not high enough for the benefits to outweigh the harms.

The most contested part of the decision concerns Black men. The committee said there was ongoing uncertainty about whether screening would do them more good than harm, and the government has pointed to their historic underrepresentation in prostate cancer trials as the reason the evidence is thin. Prostate Cancer UK expressed disappointment, and Prostate Cancer Research said it strongly disagreed because the decision excludes most men at raised risk, while the Royal College of GPs said it reflected the current limits of PSA testing.

The Trial Built to Fill the Gaps

The screening committee has said it will keep its model open to new evidence, and much of that evidence is expected to come from TRANSFORM. The £42 million trial is funded by the National Institute for Health and Care Research, which is providing £16 million, and Prostate Cancer UK, which is providing £26 million. Men are invited directly by their GP, mirroring how a real screening programme would work, and are aged 50 to 74, or from 45 for groups with poorer outcomes such as Black men. The trial tests PSA blood tests, genetic saliva tests and fast MRI scans in combinations that have never been compared at this scale. The first men were tested earlier this year in Ealing, west London. The most effective approaches will then move into a second stage involving up to 300,000 men.

“The men tested today mark the start of the biggest prostate cancer screening trial in over two decades,” said Professor Hashim Ahmed, the trial’s Chief Investigator. Alongside accepting the screening advice in June, the government committed more than £20 million to prostate cancer research and treatment, including opening TRANSFORM to all eligible Black men. The committee has agreed to review the trial’s data as it emerges, specifically to test whether the assumptions in its own model hold up, both across the whole population and for Black men.

A Narrow Start, Not a Final Answer

Put side by side, the three strands explain why this Movember feels different from earlier ones. The scale of the disease makes the absence of a screening programme stand out more each year. The screening decision shows how hard it is to justify testing healthy men when the main test available cannot reliably tell a dangerous cancer from a harmless one. And TRANSFORM is the attempt to replace that test, or combine it with better ones, so that the next decision can rest on stronger evidence, particularly for Black men, who carry twice the risk and have so far been missing from the data. The programme starting in 2027 will reach a small number of men. Whether it stays that small now depends largely on what a trial in west London and beyond finds over the next few years.

Sources: UK National Screening Committee; Department of Health and Social Care; Prostate Cancer UK; BMC Medicine (Lloyd et al, 2015); Cancer Research UK; Prostate Cancer Research; Royal College of General Practitioners; National Institute for Health and Care Research; UCLH Biomedical Research Centre.