[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-434792-105":59,"doc-detail-434792-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","the-future-of-prostate-cancer-screening-editorial","The future of prostate cancer screening - Editorial","","Editorial on the UK National Screening Committee’s 2025 draft recommendation against population-wide PSA-based prostate cancer screening, proposing instead a targeted PSA test every 2 years for men aged 45–61 with confirmed BRCA1 or BRCA2 mutations. Reviews the epidemiological burden of prostate cancer in the UK and globally, the evidence supporting mortality reduction from PSA screening, and countervailing harms from overdiagnosis and overtreatment. Discusses emerging modern diagnostics and trial programs (PRAISE-U, TRANSFORM) aiming to refine the risk–benefit balance toward better detection of clinically significant disease.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-future-of-prostate-cancer-screening-editorial/434792/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-future-of-prostate-cancer-screening-editorial/434792.png","ImageObject",300,407,{"name":92,"@type":93},"Terk","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What did the UK NSC recommend in its 2025 draft for PSA-based screening?","Question",{"text":112,"@type":113},"It advised against population-wide PSA-based prostate cancer screening for all men, and instead recommends narrowly targeted PSA screening every 2 years for men aged 45–61 with confirmed BRCA1 or BRCA2 gene mutations.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What evidence is cited that PSA screening can reduce mortality?",{"text":117,"@type":113},"The article references long follow-up data from the European Study of Prostate Cancer Screening and results from the CAP trial, both supporting a reduction in prostate-cancer-specific deaths to some extent.",{"name":119,"@type":110,"acceptedAnswer":120},"What are the main harms discussed that may result from PSA screening?",{"text":121,"@type":113},"The discussion emphasizes overdiagnosis and overtreatment, including unnecessary investigations such as biopsies and early intervention with surgery or radiotherapy that can lead to quality-of-life losses and morbidity.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},434792,1791035403,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24,"preview_page_count":4},1099525198933,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Editorial  \nThe future of prostate cancer screening  \nIn November, 2025, the UK National Screening Committee (NSC) advised against population-wide prostate specific antigen (PSA)-based prostate cancer screening for all men in their draft recommendations. Instead, the committee recommends a more narrowly targeted PSA screening every 2 years for men aged 45–61 years with confirmed BRCA1 or BRCA2 gene mutations. With the finalised recommendations due in March next year, there is likely to be much debate over this decision in the coming months.  \nProstate cancer represents a substantial public health challenge. In the UK, more than 63,000 men are diagnosed and more than 12,000 die from the disease each year. Globally, it is the most common cancer among men in more than 110 countries and is a leading cause of cancer mortality with 397,430 related deaths reported in 2022. The 2024 Lancet Commission on prostate cancer estimated that prostate cancer cases will rise from 1.4 million in 2020 to 2.9 million by 2040, with deaths increasing by approximately 85% . Prostate cancer screening has been a contentious issue due to the consequential uncertainty of the results and the delicate balance between benefits and harms. PSA testing has been widely implemented in clinical practice but is mired in controversy because of the likelihood of overdiagnosis and overtreatment. Although early detection is important, PSA-based screening might detect cancers that could be slow-growing and never have led to morbidity or mortality but miss some of the faster-growing more aggressive cancers that present a greater risk to health.  \nWith the 23-year follow-up of the European Study of Prostate Cancer Screening showing that PSA-based screening led to a 13% relative reduction in the risk of prostate-cancer-specific mortality, and the CAP trial in the UK showing reduced prostate cancer deaths ata median follow-up of 15 years, there is little room for doubt that PSA-based screening does reduce mortality to some extent. However, this is somewhat offset by studies showing that screening could cause harm. A population-based study across 26 European countries found an up to 20-fold variation in prostate cancer incidence contrasted by a corresponding five-fold variation in mortality between 1980 and 2020, indicative of overdiagnosis. The PIVOT trial demonstrated that radical prostatectomy did not significantly improve survival over observation in men with low-risk, primarily PSA-detected cancers, and microsimulation  \n© 2025 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc](http://creativecommons.org/licenses/by-nc)nd/4.0/) .  \nanalyses have suggested that modest survival benefits from PSA screening can be offset by quality-of-life losses due to overtreatment. Unnecessary further investigations such as biopsies and early intervention with surgery or radiotherapy can result in morbidity, with potential harms such as urinary incontinence, sexual dysfunction, and reduced physical functioning. The NSC decision on one hand makes sense as a precautionary approach reflecting long-standing concern that routine population-level PSA testing might subject many men to unnecessary investigationsand treatment without proportional benefit. On the other hand, specific population groups such as Black men have disproportionate burden and more frequently present with advanced disease, and excluding these groups from targeted early detection programmes leaves these individuals at greater risk. Opportunistic PSA testing will remain available and can be requested by men aged older than 50 years, but many men with risk factors might not know that they have increased risk. BRCA mutations are rare, and genetic testing is not done routinely, so status is unknown for most men, which limits the effect of the targeted screening recommendation. The decision is also contrasted by other international recommendations","cbCain41UC0uoCTJ","https://ap.wps.com/l/cbCain41UC0uoCTJ","pdf",144991,"English","# The NSC draft decision and targeted PSA screening\n## Public health burden and international debate\n## Evidence of benefit versus harms\n## Future directions: diagnostics, trials, and risk–benefit refinement","[{\"question\":\"What did the UK NSC recommend in its 2025 draft for PSA-based screening?\",\"answer\":\"It advised against population-wide PSA-based prostate cancer screening for all men, and instead recommends narrowly targeted PSA screening every 2 years for men aged 45–61 with confirmed BRCA1 or BRCA2 gene mutations.\"},{\"question\":\"What evidence is cited that PSA screening can reduce mortality?\",\"answer\":\"The article references long follow-up data from the European Study of Prostate Cancer Screening and results from the CAP trial, both supporting a reduction in prostate-cancer-specific deaths to some extent.\"},{\"question\":\"What are the main harms discussed that may result from PSA screening?\",\"answer\":\"The discussion emphasizes overdiagnosis and overtreatment, including unnecessary investigations such as biopsies and early intervention with surgery or radiotherapy that can lead to quality-of-life losses and morbidity.\"}]","The future of prostate cancer screening - Editorial | PDF",1790670582]