Men would come forward for prostate cancer screening
How can we overcome the reluctance of men to come forward for the care they need, including, for example, visiting their GP?
This is a key question that the government hopes to answer in its forthcoming men’s health strategy. it is a plan toimprove health and the way care is delivered. It would focus on improving health outcomes for men, by tackling issues like late cancer diagnoses, lower life expectancy, or stigma around asking for help.
But for one area of care at least, the NHS would be pushing at an open door.
New research by Healthwatch shows the majority of men would come forward for testing if invited as part of any future national prostate screening programme.
Healthwatch is now urging policymakers to consider men’s views, alongside clinical and economic evidence, when reaching a decision on whether (and how) to introduce a national screening programme.
One in eight men affected
Improving cancer outcomes is a key aim of the first ever national men’s health strategy, and a new national cancer plan, both due out by the end of the year.
Launching its public call for evidence on the strategy, the Department of Health and Social Care said that prostate cancer, a male-only disease, was now the most common cancer diagnosed in England.
Overall, one in eight men will develop prostate cancer, usually after the age of 50. For Black men this risk doubles to one in four and from an earlier age. Overall, the number of men dying from prostate cancer totals more than 10,000 men every year.
Behind stark statistics lie human stories. Team GB Olympian Chris Hoy last year disclosed he’d received a terminal diagnosis of prostate cancer in his late 40s, after first seeking help for shoulder pain. He’d had no symptoms of prostate problems, and the pain was caused by a secondary tumour from the spreading cancer.
The current NHS approach
There is no national prostate screening programme to routinely invite men for testing, like there is for bowel, breast and other major cancers. Wes Streeting, the Health and Social Care Secretary, said in April 2025 he backed the principle of a national screening programme, but would be ‘guided by the evidence’ from experts.
The Department of Health and Social Care didn’t ask men for their views on screening in their call for evidence on men’s health strategy, so we sought to plug this evidence gap. A national poll, of more than 3,500 men aged 18+ in England, is believed to be the first to ask men if they would take part in any future programme.
Would men attend screening?
Contrary to evidence that men are reluctant to attend other services across the health and care system, Healthwatch national findings show:
High likelihood of men attending screening
- 79% of all men said they would be likely to attend an appointment when invited, if the NHS introduced prostate screening routinely.
- This rises to 81% for Black men – an important finding for health inequalities, given their increased risk.
Likelihood increases with age
- 89% of men aged 65 to 74 in our poll said they’d be likely to attend.
- This decreased to 65% of men aged 18 to 24.
People on low incomes less likely to attend
- 67% of people who said they were financially ‘really struggling’ said they would attend if invited.
- Likelihood increased to 89% for respondents who were ‘very comfortable’ financially.
Reasons for reluctance
In the Healthwatch poll, 7% of men said they would be unlikely to take part in any future screening programme, and we asked them to select reasons why. We found:
- 25% of this group of men generally don’t like medical appointments
- 22% would prefer to wait until they had any symptoms
- 21% don’t think they’re at risk of prostate cancer.
The second figure here in particular shows a need for greater awareness, as prostate cancer is often asymptomatic until later stages.
Why all men aren’t routinely tested
There has been no national screening programme for prostate cancer because the initial diagnostic tool, the prostate-specific antigen blood test, is regarded as clinically unreliable. It sometimes shows ‘false positives’ and puts men through unnecessary anxiety and biopsies. It can also lead to detection of early and slow growing cancers, the treatment for which can cause side effects such as incontinence or erectile dysfunction, which are often more harmful than leaving the cancer alone.
However, campaigners told an MPs’ inquiry last year that a targeted national screening programme, perhaps with more advanced technology, was necessary. They argued it would stop the NHS missing cancer in men most at risk, but who find it a topic they’re too uncomfortable to raise with doctors, or simply can’t get help for due to access barriers.
The government is now waiting for the UK National Screening Committee, a group of independent experts that advises the government and NHS on which health screening programmes should be offered, to decide on six options for a targeted national screening programme. For example, screening Black men aged 45 to 70 or screening all men with a close relative who’s had prostate, breast or ovarian cancer.
How GPs respond to men’s requests for prostate-specific antigen blood tests
Navigating the existing guidance on men’s rights to a prostate-specific antigen blood test can be difficult.
Current Department of Health and Social Care guidance tells GPs not to proactively promote the prostate-specific antigen blood test to asymptomatic men, putting the onus on men to request it themselves.
However, guidance is not consistent on whether men without symptoms have the right to a prostate-specific antigen test, regardless of a doctor’s clinical judgement.
‘Men aged 50 and over who decide to have a prostate-specific antigen blood test based on this balanced information [on the pros and cons of a test, discussed with their GP] can do so for free on the NHS’, states guidance dating back to 2016, as well as the Prostate Cancer UK website.
However, the patient information page on prostate-specific antigen blood tests on the NHS website states that men ‘can ask their GP for a prostate-specific antigen blood test’ but doesn’t say whether men should have their request met.
In other Department of Health and Social Care guidance, men are told: ‘Before making a decision, you may want to talk to your GP, practice nurse, partner, family members or friends.’
This may be why people are reporting in our poll, and to their local Healthwatch, that they don’t always have their prostate-specific antigen blood test requests met.
We asked poll respondents who were aged 50 or over (1,706 in total), if they’d ever asked their GP for a prostate-specific antigen blood test and, if so, what happened. We found:
- 60% of men aged 50 and over had not requested a prostate-specific antigen blood test
- 36% of men aged 50 and over had asked for a prostate-specific antigen blood test
- Seven per cent of those who had asked for a prostate-specific antigen blood test had been refused (although due to that sample being under 100, this figure should be treated with caution).
GPs themselves have acknowledged that various or changing guidance and their own clinical judgements, can cause difficult conversations. An editorial in the British Journal of General Practice from 2023 states that GPs may be ‘mindful of the limitations of prostate-specific antigen blood tests in terms of the risks of both false positive and false negative results and the adverse consequences, and do not want to contribute to the problem of overdiagnosis of clinically insignificant prostate cancer. Some patients may interpret this hesitancy around prostate-specific antigen blood testing as GPs trying to dissuade or discourage them from having the test’.
Separate guidance to GPs covers how to deal with men who have symptoms of prostate problems. But this relies on men coming forward, and this is a key part of the problem.
Only 65% of the 328,885 men who replied to the most recent national GP Patient Survey said they’d had a GP appointment in the last six months, compared with 76% of women. Men were also less likely to take steps to seek help before making a GP appointment, such as speaking to family or friends or looking for information and advice online, compared with women.
What’s happening in Yorkshire
While the national data paints a clear picture, local trends in Yorkshire show how important it is to act quickly.
In Yorkshire, more than 4,000 men were diagnosed with prostate cancer in 2021, and around 900 died from it in the same year. In the North East and Yorkshire region, around 1 in 5 men are diagnosed too late for curative treatment. This is a much higher proportion than in places like London.
Closer to home, figures show that the first definitive treatment rate (the proportion of people starting timely cancer treatment) in Humber and North Yorkshire has dropped from 75.9% in 2024 to 71.6% in 2025, according to the Humber and North Yorkshire Cancer Alliance. This may point to delays in accessing diagnostic services or starting treatment quickly enough.
North Yorkshire Council's public health teams are working to raise awareness. This includes sharing information during Men’s Health Month and putting up posters in public toilets, leisure centres and council buildings to encourage men over 40 to speak to their GP, even if they feel well.
Healthwatch calls for change
Experts are still deciding how a prostate cancer screening programme should work. But at the same time, it’s important for decision-makers to recognise that many men are ready and willing to take part, as long as they’re asked.
Healthwatch also want clarity and consistency on the approach to testing men aged 50+ who have no symptoms but are seeking help. Currently, many men are left in distress when a request is denied by their GP (or their practice won’t let them book an appointment with a doctor to discuss it initially) and they don’t know what to do next.
Taking action on prostate cancer
Healthwatch is calling for things to change. We want:
1. Men’s voices included in decisions about national screening
Policymakers (the people who help create the rules, plans or laws) should consider men’s experiences and views alongside clinical and economic evidence when deciding whether to introduce a national prostate cancer screening programme. Clinical and economic evidence helps policymakers decide if a health intervention is both effective for patients and affordable for the NHS.
While the design of any future programme should be based on clinical expertise, Healthwatch evidence shows that men, particularly those at higher risk, such as Black men, are willing to take up a screening invitation. This should be taken into account as decisions on screening are made in the coming months.
2. Provide clear, consistent national guidance on testing for men without symptoms
Guidance should make it clear whether:
- Men over 50 are entitled to book an appointment to discuss the benefits and risks of the prostate‑specific antigen blood test.
- The final decision to have this test lies with the clinician or the patient.
- Men who are refused the test but still wish to have it can take further action or seek another opinion.
3. Improve awareness of prostate cancer
Increase public understanding of prostate cancer symptoms, risk factors, and the importance of seeking medical advice early, especially for those at higher risk.
About the survey
A company called Savanta asked 3,575 men aged 18 and over across England about their views between 13 and 27 June 2025. The results were adjusted to reflect the country’s population in terms of age, region, and social background.
