The UK National Screening Committee (UK NSC) recommends targeted prostate cancer screening every 2 years for men aged 45-61 with a BRCA2 pathogenic variant and a family history of pancreatic, prostate, breast or ovarian cancer.
This recommendation reflects strong evidence that this group is more likely to develop aggressive prostate cancer. As a result, the benefits of screening are more likely to outweigh the harms.
The UK Government has accepted this recommendation. NHS England plans to establish a programme from 2027, whilst other UK nations are yet to announce implementation dates.
For further information and commentary, read our latest cancer news article: UK NSC recommends targeted prostate cancer screening (May 2026).
The UK NSC reviewed the available evidence and found that there is not enough evidence to recommend prostate cancer screening for:
Black men
Men with a relevant family history of cancer without BRCA2 pathogenic variants
Men with pathogenic variants in BRCA1
The general population
These groups are more likely to develop prostate cancer. However, it is still unclear whether they are more likely to develop aggressive disease. The committee concluded that, for these groups, the harms of PSA screening are likely to outweigh the benefits.
PSA testing is not recommended for patients without symptoms who are not eligible for targeted screening. However, some patients may still ask for a PSA test because they are concerned about prostate cancer.
The Prostate Cancer Risk Management Programme (PCRMP) previously provided advice for GPs on counselling asymptomatic patients on PSA testing. This document has now been retired. Updated advice is available in the NICE Clinical Knowledge Summary (CKS) and on NHS.net for patients.
If an asymptomatic patient asks for a PSA test, it’s important to:
Support informed decision-making by providing clear information about the PSA test and discussing the potential harms and benefits. To support these conversations, we've developed a guide you can download below to share with people before or during consultations To support these conversations, we've developed a guide to PSA testing for people without symptoms. This could be useful to share with people asking about PSA testing before or during consultations
Document the discussion
If a patient has any possible symptoms of prostate cancer, follow the suspected prostate cancer referral guidelines.
Until a targeted screening programme is established, GPs should continue to follow the UK Cancer Genetics Group recommendation. Men with a confirmed BRCA2 pathogenic variant should be offered annual PSA tests from age 40 and referred onwards if PSA >3ng/mL.
Patients with a relevant family history of cancer may benefit from referral to clinical genetics or familial cancer services. Follow national and local guidance as signposted below.
NICE referral guidance for people with a family history of breast cancer (CG164) and ovarian cancer (NG241) and people with an inherited high risk of pancreatic cancer (NG85).
The NHS England National Genomics Education Programme provides example clinical scenarios for managing patients with a family history of cancer, and specifically prostate cancer, breast and/or ovarian cancer and bowel cancer
The National Genomic Test Directory outlines eligibility criteria for genetic testing.
The All Wales Medical Genomics Service has referral criteria for family history of breast, ovarian, and colorectal cancer.
NICE referral guidance for people with a family history of breast cancer (CG164) and people with an inherited high risk of pancreatic cancer (NG85).
Refer to region-specific guidance for cancer genetic services. This outlines the referral guidance for people with a family history of breast, ovarian and colorectal cancers.
Refer to Belfast Health and Social Care Trust. This outlines referral guidance for people with a family history of breast and ovarian cancer and Lynch syndrome.
After a referral, specialist services will assess the patient's family history and other clinical factors. They will then decide whether genetic testing or further management is needed.
If you're unsure whether to refer, seek advice from a specialist service. This may be a clinical genomics or familial cancer service, depending on local arrangements.
We are supporting an expert advisory group, co-chaired by the UK Cancer Genetics Group and the Royal College of General Practice. The group are developing more practical advice on assessing prostate cancer risk in people with a family history of prostate cancer who don’t have symptoms. This advice aims to help primary care teams identify who can be reassured and managed in primary care, and who may need a referral and further assessment. Advice is expected to be published in autumn 2026.
GatewayC ‘The role of genomics in primary care’ course (England and Wales only) (February 2025)
GatewayC ‘When should primary care be concerned about a family history of prostate cancer’ article (June 2026)
For guidance and advice about PSA testing with symptoms, visit our PSA testing in patients without symptoms webpage.
PSA testing for patients with symptomsUK National Screening Committee. Prostate cancer screening recommendation. Accessed May 2026.
