Prostate cancer in the UK and the NHS

1. 1
   Before any symptoms: what the NHS does and does not offerNo population screening. From 2027 in England, a PSA test every two years between 45 and 61 for men with a pathogenic germline BRCA2 variant and a family history of breast, ovarian, pancreatic or prostate cancer. Anyone else with a prostate can ask a GP for a PSA test after a discussion of benefits and harmsTarget Rollout expected 2027 (England); next UK NSC review estimated 2029 to 2030

   The UK National Screening Committee reviewed prostate cancer screening across 2025 and 2026 and published its recommendation after a meeting on 26 March 2026. It is the first time the committee has recommended any form of prostate cancer screening, and it is deliberately narrow. It recommends a nationally managed approach to biennial PSA testing in men aged 45 to 61 with pathogenic germline BRCA2 variants and a family history of breast, ovarian, pancreatic or prostate cancer; it recommends that the best way of identifying and inviting that group be evaluated over time; and it does not recommend population screening or targeted screening for any other risk group. The reasoning is in the committee's own coversheet. A model built by the Sheffield Centre for Health and Related Research, validated against the CAP and ERSPC trials, ran a modern pathway of PSA, then multiparametric MRI, then local anaesthetic transperineal biopsy. Screening everyone would only slightly reduce deaths while causing a very large number of men to be treated for cancer that would never have harmed them: around 40 to 50 percent of screen-detected cancers are slow growing, and at age 60 the model predicted that half of screen-detected cases would be overdiagnosed. The committee found the same problem in men with a family history but no BRCA2 variant. For men with a pathogenic BRCA2 variant and a relevant family history, repeat PSA testing was judged likely to be both clinically and cost effective at the 20,000 pound per quality-adjusted life year threshold. BRCA1 carriers were in the draft and were dropped from the final recommendation after geneticists advised that the increased risk was not large enough. The committee consulted for twelve weeks, from 28 November 2025 to 23 February 2026, and received 974 comments. Most respondents disagreed: 834 opposed the draft, 796 of them members of the public, and the organisations opposing included the British Association of Urological Surgeons, the NHS Race and Health Observatory, the Black Equity Organisation, the Caribbean and African Health Network and Prostate Scotland. Cancer Research UK, Prostate Cancer UK, the Royal College of General Practitioners and the Royal College of Nursing agreed with it. The committee's answer to the personal accounts it received is worth reading: the stories come almost entirely from men whose cancer was found by a PSA test, and a programme has to be judged on the population it would invite. Ministers in England agreed to implement the recommendation on 2 June 2026, with rollout expected in 2027. The committee has said it will keep the model open so that new evidence, including TRANSFORM's, can be fed in, and the next review is estimated for 2029 to 2030.

   Sources: UK National Screening Committee: prostate cancer recommendation, from the March 2026 review. Screening is recommended, but only as a targeted programme: biennial PSA testing for men aged 45 to 61 with a pathogenic BRCA2 variant and a family history of breast, ovarian, pancreatic or prostate cancer. Population screening is not recommended, and nor is targeted screening for any other risk group. Next review estimated 2029 to 2030 (2026-03); UK National Screening Committee: screening for prostate cancer, coversheet of 26 March 2026 (the modelling summary by strategy, the 12-week consultation with its 974 comments, and the recommendation in full with its rationale for excluding BRCA1 carriers, Black men and family history without a BRCA2 variant) (2026-03-26); UK National Screening Committee: prostate cancer evidence review, 2026 (2026-03); UK National Screening Committee: prostate cancer cost-effectiveness model, built by the Sheffield Centre for Health and Related Research (2026-03); Department of Health and Social Care: equality impact assessment, introduction of a targeted prostate cancer screening programme (published 2 June 2026). Ministers in England have agreed to implement biennial PSA testing for men aged 45 to 61 with a pathogenic germline BRCA2 variant and a relevant family history. Carries the England case and death counts, the survival figure, the lifetime risk by ethnic group and the age-standardised incidence rates for Black and White men (2026-06-02); NHS: PSA test (the page the withdrawn Prostate Cancer Risk Management Programme addresses now redirect to). It says routine PSA testing is not offered on the NHS unless genetic tests have shown a faulty BRCA2 gene, and that anyone with a prostate can ask a GP about the test. Page last reviewed 2 September 2024 (2024-09-02)

2. 2
   What screening would do to 1,000 men, on the committee's own numbersOf 1,000 men aged 50 to 60 screened with a PSA test: around 100 have a positive PSA, 34 have a positive MRI and a biopsy, 28 are diagnosed with prostate cancer, up to 2 lives are saved and up to 20 are overdiagnosed, 12 of them overtreated

   Cancer Research UK designed this infographic and the UK National Screening Committee calculated the figures, mostly from the GOTEBORG-2 trial for everything up to diagnosis, from the CAP and ERSPC trials for lives saved, and from ProtecT for harms. Of the 28 men diagnosed, 10 would likely be offered active surveillance, of whom around 6 switch to radiotherapy or surgery within 15 years; 13 would likely be offered surgery, radiotherapy or active surveillance, and clinical experts think many of these grade group 2 cancers are over-detected and overtreated; 4 would likely need surgery or radiotherapy and 1 some other treatment. The harms at five years are from ProtecT and apply to every man treated, whether he needed it or not: of men who had surgery, almost 20 percent leak urine and 50 percent have erectile problems; of men who had radiotherapy, almost 40 percent have erectile problems and around 5 percent have bowel problems. Men on active surveillance are not unharmed either: the anxiety of the diagnosis and the follow-up testing, and the risk of switching to radical treatment unnecessarily or of not being treated when they need it. This table is the honest version of the screening argument and it is published by the committee, not by its critics.

   Sources: UK National Screening Committee and Cancer Research UK: modelling the outcomes of prostate cancer screening (what happens to 1,000 men aged 50 to 60 screened with PSA, with its assumptions and references) (2026-04-16); UK National Screening Committee: screening for prostate cancer, coversheet of 26 March 2026 (the modelling summary by strategy, the 12-week consultation with its 974 comments, and the recommendation in full with its rationale for excluding BRCA1 carriers, Black men and family history without a BRCA2 variant) (2026-03-26)

3. 3
   Risk in Black men, and what the NHS does about itNo different NHS pathway. Prostate Cancer UK recommends Black men over 45 discuss their risk and a PSA test with a GP; a 2024 UK clinical consensus says the same; NICE says only that a black African-Caribbean family background is one of the risk factors to discuss when deciding about a biopsy

   The figures are real and old. Lloyd and colleagues, working with Public Health England and Prostate Cancer UK, calculated lifetime risk by major ethnic group from England's 2008 to 2010 incidence and mortality: a 29.3 percent lifetime risk of diagnosis in Black men (range 23.5 to 37.2) against 13.3 percent in White men (13.2 to 15.0) and 7.9 percent in Asian men, which is where one in four against one in eight comes from. Lifetime risk of dying of prostate cancer was 8.7 percent in Black men against 4.2 percent in White men. Delon and colleagues put the modern incidence rate ratio at 2.1 for Black against White males in England for 2013 to 2017, and showed it is strongly age-dependent: 2.9 times higher at ages 0 to 64 and 1.9 times higher at 65 and over. The government's own equality impact assessment gives the age-standardised incidence rate as 166 per 100,000 in Black men against 56.4 in White men, with a 30 percent higher mortality rate. The most important finding in the Lloyd paper is the one least often quoted. Within every ethnic group the ratio of lifetime death risk to lifetime diagnosis risk was close to one third, so once a man has been diagnosed his chance of dying of the disease is about the same whatever his ethnicity. The excess is in incidence, not in case fatality. What the NHS does about it is almost nothing formal. NICE NG131 recommendation 1.2.6, unchanged since 2008, lists a black African-Caribbean family background among the risk factors to weigh when deciding about MRI or biopsy; there is no recommendation anywhere in NG131 or NG12 for earlier or more frequent PSA discussion by ethnicity. The recommendation that Black men be proactively offered that discussion from 45 comes from a 2024 UK clinical consensus published in the British Journal of General Practice, and from Prostate Cancer UK, not from NICE or from a screening programme. The screening committee's position is that the balance of benefit and harm in Black men is unknown, because too few Black men have been recruited into screening trials, and that TRANSFORM is the way to find out.

   Sources: Lloyd T, Hounsome L, Mehay A, Mee S, Verne J, Cooper A. Lifetime risk of being diagnosed with, or dying from, prostate cancer by major ethnic group in England 2008-2010. BMC Medicine 2015;13:171. The source of the one-in-four figure, with the ranges and the finding that case fatality is the same in every ethnic group (2015-07-30); Delon C, Brown KF, Payne NWS, Kotrotsios Y, Vernon S, Shelton J. Differences in cancer incidence by broad ethnic group in England, 2013-2017. British Journal of Cancer 2022;126:1765-1773. Prostate cancer incidence rate ratio, Black against White males, 2.1 overall, 2.9 at ages 0 to 64 and 1.9 at 65 and over (2022-03-01); Department of Health and Social Care: equality impact assessment, introduction of a targeted prostate cancer screening programme (published 2 June 2026). Ministers in England have agreed to implement biennial PSA testing for men aged 45 to 61 with a pathogenic germline BRCA2 variant and a relevant family history. Carries the England case and death counts, the survival figure, the lifetime risk by ethnic group and the age-standardised incidence rates for Black and White men (2026-06-02); NICE NG131 recommendations: multiparametric MRI first line reported on a 5-point Likert scale (1.2.2), MRI-influenced biopsy at Likert 3 or more (1.2.3), the Cambridge Prognostic Group table (1.2.15), treatment by risk group (1.3.8 to 1.3.12), the active surveillance protocol (1.3.14), 60 Gy in 20 fractions (1.3.19) and the follow-up PSA intervals (1.3.47) (2021-12-15); Harding TA, Martin RM and others. Optimising the use of the prostate-specific antigen blood test in asymptomatic men for early prostate cancer detection in primary care: report from a UK clinical consensus. British Journal of General Practice 2024;74(745):e534-e543. The consensus, not NICE, is the source of the advice that PSA testing should be proactively discussed with Black men from 45 (2024-07-23); Prostate Cancer UK: Black men and prostate cancer. One in four Black men will get prostate cancer, double the risk of other men; risk rises from 45; and the charity recommends Black men over 45 speak to their GP about their risk and about having a PSA test (2026-09-25); UK National Screening Committee: screening for prostate cancer, coversheet of 26 March 2026 (the modelling summary by strategy, the 12-week consultation with its 974 comments, and the recommendation in full with its rationale for excluding BRCA1 carriers, Black men and family history without a BRCA2 variant) (2026-03-26)

4. 4
   Day 0: the PSA threshold that triggers a referralRefer on a suspected cancer pathway if the prostate feels malignant on digital rectal examination (NG12 1.6.1). Consider referring if the PSA is above the age-specific threshold in NG12 table 2: more than 2.5 micrograms per litre at 40 to 49, 3.5 at 50 to 59, 4.5 at 60 to 69 and 6.5 at 70 to 79, with clinical judgement below 40 and above 79

   The age-specific table came into NG12 in the December 2021 update, replacing a single fixed threshold, and the April 2026 update did not touch it. Two details are easy to get backwards and both matter. First, an abnormal digital rectal examination is a referral, not a consideration: recommendation 1.6.1 says refer. A raised PSA is only a consideration, because recommendation 1.6.3 says consider referring, taking the person's preferences and comorbidities into account. Second, this table is for men with possible symptoms, which recommendation 1.6.2 defines as any lower urinary tract symptom, erectile dysfunction or visible haematuria. NICE has no threshold for an asymptomatic man, because NICE has never written guidance on screening; that was the withdrawn risk management programme's job and is now the screening committee's. NG131 recommendation 1.2.6 adds the rule that keeps the pathway honest: do not automatically offer a biopsy on the basis of the PSA alone.

   Sources: NICE NG12: suspected cancer, recommendations organised by site of cancer (prostate is 1.6.1 to 1.6.3 with the age-specific PSA thresholds in table 2). Published 23 June 2015, last updated 15 April 2026 (2026-04-15); NICE NG131 recommendations: multiparametric MRI first line reported on a 5-point Likert scale (1.2.2), MRI-influenced biopsy at Likert 3 or more (1.2.3), the Cambridge Prognostic Group table (1.2.15), treatment by risk group (1.3.8 to 1.3.12), the active surveillance protocol (1.3.14), 60 Gy in 20 fractions (1.3.19) and the follow-up PSA intervals (1.3.47) (2021-12-15); NHS: PSA test (the page the withdrawn Prostate Cancer Risk Management Programme addresses now redirect to). It says routine PSA testing is not offered on the NHS unless genetic tests have shown a faulty BRCA2 gene, and that anyone with a prostate can ask a GP about the test. Page last reviewed 2 September 2024 (2024-09-02)

5. 5
   28 days: diagnosis or all-clearFaster Diagnosis Standard: told you have cancer, or that you do not, within 28 days of the referralTarget 80% from quarter 1 of 2026/27

   Suspected urological cancer excluding testicular is the worst-performing tumour group in England on this standard. In July 2026, 15,077 of 22,234 people were told within 28 days, or 67.8 percent, against 79.3 percent across all cancers, a gap of eleven and a half points. The referral volume is large and growing: 24,449 urgent suspected cancer referrals for suspected urological malignancy in that single month. The reason the standard is hard here is structural rather than clinical. A prostate pathway needs a PSA, a clinic appointment, a multiparametric MRI reported by a radiologist confident enough to give a Likert score, and then, for most men with a Likert 3 or more, a biopsy under local anaesthetic through the perineum and a pathologist to grade it. Every one of those steps is a queue.

   Sources: NHS England: cancer waiting times monthly combined data, April to July 2026, provisional. The prostate and urological rows for July 2026: 67.8 percent on the 28-day standard for suspected urological malignancies, 68.2 percent on the 62-day standard for prostate cancer overall, 62.8 percent on the urgent suspected cancer route and 85.2 percent on the consultant upgrade route, and 91.4 percent on the 31-day standard (2026-09-10); NHS England: cancer waiting times statistical release for July 2026, provider based, provisional (released 10 September 2026) (2026-09-10); GOV.UK: waiting times for suspected and diagnosed cancer patients, July 2026 (the definitions of the 28, 31 and 62 day standards; published 10 September 2026) (2026-09-10); NHS England: cancer waiting times statistics (the page answered HTTP 202 with an empty web application firewall challenge to OnCo on 25 September 2026)

6. 6
   Multiparametric MRI, before any needleMultiparametric MRI as the first-line investigation for suspected clinically localised prostate cancer, reported on a 5-point Likert scale (NG131 1.2.2). MRI-influenced biopsy if the Likert score is 3 or more (1.2.3). Consider omitting biopsy at Likert 1 or 2 after a shared decision (1.2.4)

   This is the British contribution to prostate cancer diagnosis and it is built on PROMIS, a UK study that gave 576 men an MRI, a standard transrectal biopsy and a template mapping biopsy and compared all three. Multiparametric MRI had a sensitivity of 93 percent for clinically significant cancer against 48 percent for the standard biopsy, and using it as a triage test would spare 27 percent of men a primary biopsy while finding up to 18 percent more clinically significant cancers. NG131 recommendation 1.2.1 sets the limit: do not routinely offer MRI to someone who would not be able to have radical treatment anyway. Note what the NHS reports and what it does not. NICE asks for a five-point Likert score, which is a radiologist's overall judgement, not a PI-RADS category; PI-RADS is used internationally and in research but the NHS standard as written by NICE is Likert. Box 1 of NG131 gives the numbers for the conversation after a Likert 1 or 2 scan: between 11 and 28 in 100 men with a low-risk MRI actually have clinically significant cancer, prostate biopsies find less than half of the clinically significant cancers MRI misses, and between 18 and 23 in 100 get a diagnosis of clinically insignificant cancer if they are biopsied. If no biopsy is done, recommendation 1.2.11 asks for a repeat PSA at three to six months and sets the re-referral triggers: a PSA density above 0.15 nanograms per millilitre per millilitre or a PSA velocity above 0.75 nanograms per millilitre per year, or a strong family history.

   Sources: NICE NG131 recommendations: multiparametric MRI first line reported on a 5-point Likert scale (1.2.2), MRI-influenced biopsy at Likert 3 or more (1.2.3), the Cambridge Prognostic Group table (1.2.15), treatment by risk group (1.3.8 to 1.3.12), the active surveillance protocol (1.3.14), 60 Gy in 20 fractions (1.3.19) and the follow-up PSA intervals (1.3.47) (2021-12-15); Ahmed HU and others. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 2017;389:815-822 (PMID 28110982) (2017-02-25); NICE HTG678 (formerly DG53): MRI fusion biopsy systems for diagnosing prostate cancer (24 May 2023). There is not enough evidence to recommend routine adoption; centres already using them may continue but are asked to collect data (2023-05-24)

7. 7
   The biopsy, and why it is now through the perineumLocal anaesthetic transperineal biopsy with a freehand needle positioning device is recommended as an option (NICE HTG680). NG131 1.2.5 says do not offer mapping transperineal template biopsy as part of an initial assessment outside a clinical trial

   NG131 itself makes no recommendation between transrectal and transperineal biopsy, and says so: box 1's figures come from PROMIS and ProtecT, which used transrectal ultrasound-guided biopsy, and NICE states there is no equivalent data for other types. The move to the perineum was made by a separate piece of NICE guidance, HTG680, formerly diagnostics guidance DG54, published 1 June 2023. It recommends local anaesthetic transperineal biopsy using the PrecisionPoint freehand device, and three other freehand devices with less evidence behind them, on the basis that cancer detection is no different but infection and sepsis are less common. It found the evidence insufficient to recommend the CamPROBE double freehand device, and it asked centres to join TRANSLATE, the randomised comparison of transrectal against local anaesthetic transperineal biopsy. The harms NG131 lists for transrectal biopsy are the reason this mattered: sepsis in a little under 1 in 100, 44 in 100 reporting pain, 20 in 100 a fever, 66 in 100 blood in the urine and 90 in 100 blood in the semen, which lasts more than two weeks in 60 of them. Template mapping biopsy, taking two or three cores from each of 20 sites, stays where it was: HTG237 supports it after a negative or equivocal biopsy, and NG131 1.2.5 keeps it out of the initial assessment. MRI fusion biopsy systems are not recommended for routine adoption: HTG678 says the evidence is not there and asks centres already using them to collect data.

   Sources: NICE HTG680 (formerly DG54): transperineal biopsy for diagnosing prostate cancer (1 June 2023). Local anaesthetic transperineal biopsy with the PrecisionPoint freehand device is recommended, with three other freehand devices, and centres are asked to join the TRANSLATE randomised comparison with transrectal biopsy (2023-06-01); NICE NG131 recommendations: multiparametric MRI first line reported on a 5-point Likert scale (1.2.2), MRI-influenced biopsy at Likert 3 or more (1.2.3), the Cambridge Prognostic Group table (1.2.15), treatment by risk group (1.3.8 to 1.3.12), the active surveillance protocol (1.3.14), 60 Gy in 20 fractions (1.3.19) and the follow-up PSA intervals (1.3.47) (2021-12-15); NICE HTG237 (formerly IPG364): transperineal template biopsy and mapping of the prostate (27 October 2010). Increased diagnostic yield after a negative or equivocal biopsy; use as a mapping technique for focal therapy or inside active surveillance needs special arrangements (2010-10-27); NICE HTG678 (formerly DG53): MRI fusion biopsy systems for diagnosing prostate cancer (24 May 2023). There is not enough evidence to recommend routine adoption; centres already using them may continue but are asked to collect data (2023-05-24)

8. 8
   The urological cancer multidisciplinary team, and the Cambridge Prognostic GroupUrological cancer multidisciplinary teams should assign a risk category to everyone with newly diagnosed localised or locally advanced prostate cancer, using the Cambridge Prognostic Group table (NG131 1.2.15). Do not routinely offer isotope bone scans in CPG 1 or 2 (1.2.16)

   NICE replaced its own three-tier low, intermediate and high risk table in the December 2021 amendment and its whole treatment section is now written in Cambridge Prognostic Group numbers. CPG 1 is Gleason 6, grade group 1, with a PSA below 10 and stage T1 to T2. CPG 2 is Gleason 3+4 or a PSA of 10 to 20, with stage T1 to T2. CPG 3 is Gleason 3+4 and a PSA of 10 to 20 and stage T1 to T2, or Gleason 4+3 at stage T1 to T2. CPG 4 is one of Gleason 8, a PSA above 20, or stage T3. CPG 5 is two or more of those, or Gleason 9 to 10, or stage T4. Roughly, CPG 1 maps to what used to be called low risk, CPG 2 and 3 to intermediate and CPG 4 and 5 to high, but the boundaries are not identical and NICE's recommendations are written in the new numbers, so it is worth knowing which group you are in rather than which band. Note that the table uses micrograms per litre while other NG131 recommendations use nanograms per millilitre; the two are the same quantity. Staging follows from the group. Bone scans are not routine in CPG 1 or 2. NG131 says nothing at all about PSMA PET-CT: NICE considered it in a 2023 exceptional surveillance review, noted a study reporting 27 percent greater accuracy than conventional imaging and topic experts' concern about geographical inequity in access, and decided not to change the bone-scan recommendations. Any claim that NICE recommends PSMA or choline PET-CT at a given PSA after relapse is not NICE; it is European Association of Urology guidance.

   Sources: NICE NG131 recommendations: multiparametric MRI first line reported on a 5-point Likert scale (1.2.2), MRI-influenced biopsy at Likert 3 or more (1.2.3), the Cambridge Prognostic Group table (1.2.15), treatment by risk group (1.3.8 to 1.3.12), the active surveillance protocol (1.3.14), 60 Gy in 20 fractions (1.3.19) and the follow-up PSA intervals (1.3.47) (2021-12-15); NICE: 2023 exceptional surveillance of NG131 (2 March 2023), which decided not to update the bone-scan recommendations and said it would continue monitoring the evidence on gallium-68 PSMA PET-CT (2023-03-02); NICE QS91: prostate cancer, quality standard, five statements (published 11 June 2015, last updated 30 December 2021) (2021-12-30)

9. 9
   31 days: decision to first treatmentTreatment starts within 31 days of the decision to treatTarget 96% (England); 95% (Scotland); 98% (Northern Ireland)

   Prostate cancer does comparatively well on this measure, which is the one that starts once the queue for diagnosis is behind you. In England in July 2026, 8,244 of 9,015 prostate treatments started within 31 days, or 91.4 percent, against 92.5 percent for all cancers; split by stage it was 96.7 percent for first treatments and 86.4 percent for subsequent ones, and across April to July 2026 the prostate figure was 90.8 percent. In Scotland in the quarter to 31 March 2026, 1,478 of 1,612 prostate referrals were treated within 31 days, 91.7 percent, with a median wait of two days against an all-cancer figure of 94.5 percent. Northern Ireland publishes urological cancer as one group: 179 of 204 in January 2026, 172 of 200 in February and 171 of 204 in March, against a 98 percent target.

   Sources: NHS England: cancer waiting times monthly combined data, April to July 2026, provisional. The prostate and urological rows for July 2026: 67.8 percent on the 28-day standard for suspected urological malignancies, 68.2 percent on the 62-day standard for prostate cancer overall, 62.8 percent on the urgent suspected cancer route and 85.2 percent on the consultant upgrade route, and 91.4 percent on the 31-day standard (2026-09-10); Public Health Scotland: cancer waiting times, table 1, compliance with standard (quarter ending 31 March 2026). Urology overall 47.5 percent at 62 days; prostate 39.8 percent on 1,044 eligible referrals, with a median wait of 77 days and a maximum of 336; by board from 10.5 percent in Grampian and 17.3 percent in Lothian to 81.1 percent in Lanarkshire. Prostate 31-day compliance 91.7 percent on 1,612 referrals (2026-06-30); Northern Ireland Department of Health: cancer waiting times statistics by HSC trust and tumour site, January to March 2026. Urological cancer 31-day performance: 179 of 204 in January, 172 of 200 in February and 171 of 204 in March, against a 98 percent target (2026-07-02); GOV.UK: waiting times for suspected and diagnosed cancer patients, July 2026 (the definitions of the 28, 31 and 62 day standards; published 10 September 2026) (2026-09-10)

10. 10
    62 days: referral to first treatment, the standard prostate cancer fails worstFirst treatment within 62 days of the urgent referralTarget 85% (England); 95% (Scotland); 75% (Wales); 95% (Northern Ireland)

    In England in July 2026, 2,888 of 4,234 men with prostate cancer started treatment within 62 days, 68.2 percent, against 71.2 percent across all cancers. The route matters more here than in most cancers: 62.8 percent on the urgent suspected cancer route, 85.2 percent on the consultant upgrade route, and only three men came through a screening route at all. Across April to July 2026 the prostate figure was 65.8 percent on 16,781 treatments, against 70.2 percent for all cancers. Scotland's figure is far worse and is the single most striking number on this page. In the quarter to 31 March 2026, 415 of 1,044 men with prostate cancer started treatment within 62 days: 39.8 percent, against a 95 percent standard and an all-cancer figure of 72.2 percent. Urology as a whole was 47.5 percent, the worst of any tumour group. The median wait was 77 days and the longest was 336. The spread between boards is extraordinary: 10.5 percent in NHS Grampian, where the median wait was 160 days, and 17.3 percent in NHS Lothian, against 81.1 percent in NHS Lanarkshire and 66.7 percent in NHS Highland. The two figures are not directly comparable and should not be read as a league table. England stops the 62-day clock for men in the lower Cambridge Prognostic Groups at the point active monitoring is agreed, counting that as a first treatment; it could not be established whether Scotland or Wales do the same, because neither publication mentions active monitoring at all. Wales publishes no tumour-site figure: 60.1 percent of all suspected cancer pathways started treatment within 62 days in July 2026, against a 75 percent target, on 2,248 treatments and 18,429 new pathways opened. Northern Ireland withheld its 62-day figures from the March 2026 release and republished the whole series on 11 September 2026 after finding an error in its new patient administration system's suspension logic: the corrected all-cancer performance for the quarter to March 2026 is 29.6 percent, and every quarter since December 2024 was revised down, by as much as 4.5 percentage points.

    Sources: NHS England: cancer waiting times monthly combined data, April to July 2026, provisional. The prostate and urological rows for July 2026: 67.8 percent on the 28-day standard for suspected urological malignancies, 68.2 percent on the 62-day standard for prostate cancer overall, 62.8 percent on the urgent suspected cancer route and 85.2 percent on the consultant upgrade route, and 91.4 percent on the 31-day standard (2026-09-10); Public Health Scotland: cancer waiting times, table 1, compliance with standard (quarter ending 31 March 2026). Urology overall 47.5 percent at 62 days; prostate 39.8 percent on 1,044 eligible referrals, with a median wait of 77 days and a maximum of 336; by board from 10.5 percent in Grampian and 17.3 percent in Lothian to 81.1 percent in Lanarkshire. Prostate 31-day compliance 91.7 percent on 1,612 referrals (2026-06-30); Public Health Scotland: cancer waiting times, 1 January to 31 March 2026 (published 30 June 2026): 72.2 percent of 4,668 eligible referrals started treatment within 62 days, against a 95 percent standard met by no NHS board, and 94.5 percent within 31 days (2026-06-30); Welsh Government: NHS activity and performance summary, July and August 2026 (published 17 September 2026): 2,248 pathways started treatment in July and 60.1 percent started within 62 days of first being suspected of cancer, against a 75 percent target; 18,429 new suspected cancer pathways were opened, the second highest since records began. No prostate-specific figure is published (2026-09-17); Northern Ireland Department of Health: revised 62-day waits for quarters ending December 2023 to March 2026 (published 11 September 2026), after an error in the encompass patient administration system's suspension logic inflated performance: 29.6 percent in the quarter to 31 March 2026, and every earlier quarter revised down by up to 4.5 percentage points (2026-09-11); GOV.UK: waiting times for suspected and diagnosed cancer patients, July 2026 (the definitions of the 28, 31 and 62 day standards; published 10 September 2026) (2026-09-10)

11. 11
    Active surveillance, which is a treatment decision and not a delayOffer active surveillance in CPG 1; offer a choice of active surveillance, radical prostatectomy or radical radiotherapy in CPG 2; consider it in CPG 3; do not offer it in CPG 4 or 5 (NG131 1.3.8 to 1.3.11). The protocol in table 2: PSA every 3 to 4 months in year 1, a digital rectal examination at 12 months and MRI at 12 to 18 months, then PSA every 6 months and an examination every 12

    NG131 gives active surveillance to CPG 1 as the offer, not as an option of last resort, and box 2 of the guideline explains why in ProtecT's numbers: at ten years, 98 in 100 men offered active monitoring had not died of prostate cancer, against 99 in 100 offered surgery and 99 in 100 offered radiotherapy. What differed was progression (21 against 8 and 8 in 100) and metastasis (8 against 3 and 3). What also differed was harm: at six months, moderate to severe urinary incontinence was reported by 4 in 100 on active monitoring, 19 after surgery and 6 after radiotherapy, and moderate or severe erectile dysfunction by 29, 66 and 48. Recommendation 1.3.13 asks for an MRI for anyone on surveillance who has not had one, and a new MRI-influenced biopsy if the scan and the biopsy disagree. The audit measures this inversely and finds the largest variation on the page. Its second indicator is the proportion of men with CPG 1 localised cancer who nonetheless receive radical treatment, where lower is better: 7 percent nationally in England, 383 of 5,453 men diagnosed in 2022, but ranging from 2 to 40 percent between the 45 specialist multidisciplinary teams. A twentyfold spread on a decision that NICE has written down.

    Sources: NICE NG131 recommendations: multiparametric MRI first line reported on a 5-point Likert scale (1.2.2), MRI-influenced biopsy at Likert 3 or more (1.2.3), the Cambridge Prognostic Group table (1.2.15), treatment by risk group (1.3.8 to 1.3.12), the active surveillance protocol (1.3.14), 60 Gy in 20 fractions (1.3.19) and the follow-up PSA intervals (1.3.47) (2021-12-15); National Prostate Cancer Audit: State of the Nation Report 2025, full report. 58,218 men diagnosed in England in 2024, up 9 percent on 2023; 9,590 radical prostatectomies and 20,782 radical radiotherapy courses in 2024; the eight performance indicators with their provider ranges; and the data completeness figures (2025-10); Hamdy FC and others. Fifteen-year outcomes after monitoring, surgery, or radiotherapy for prostate cancer. New England Journal of Medicine 2023;388:1547-1558 (PMID 36912538) (2023-03-11)

12. 12
    Surgery and radiotherapy, and what the NHS commissionsOffer radical prostatectomy or radical radiotherapy in CPG 3, 4 and 5 (NG131 1.3.10 and 1.3.12). Hypofractionated radiotherapy of 60 Gy in 20 fractions with image-guided intensity modulated radiation therapy (1.3.19). Six months of androgen deprivation therapy with radical radiotherapy in CPG 2 to 5 (1.3.22), continued to three years in CPG 4 and 5 (1.3.23)

    The 60 Gy in 20 fractions schedule is British: CHHiP randomised 3,216 men across 71 centres between 74 Gy in 37 fractions, 60 Gy in 20 and 57 Gy in 19, and found 60 Gy non-inferior with no extra late toxicity, cutting a seven and a half week course to four. In June 2026 NHS England went further and made stereotactic ablative radiotherapy, five fractions of 36.25 Gy over one to two weeks, a routinely commissioned option for low and intermediate risk localised disease in men who do not need androgen deprivation therapy. That policy is written on PACE-B's eligibility criteria and cites the trial by name; it excludes Gleason 4+3, an international prostate symptom score of 20 or more, and anything above intermediate risk, and it requires a centre to have at least two subspecialist clinical oncologists with prostate SABR experience and to pass radiotherapy trials quality assurance before offering it. NHS England expects it at all 48 English radiotherapy providers and estimates around 3,500 men a year will choose it. On the surgical side, NG131 recommendations 1.3.17 and 1.3.18 ask commissioners to consider providing robotic surgery and to base robotic systems in centres expected to do at least 150 robot-assisted laparoscopic radical prostatectomies a year. Volumes are rising fast: England did 9,590 radical prostatectomies in 2024, 13 percent more than in 2023, and 20,782 courses of radical radiotherapy, also 13 percent more. The audit's third indicator asks the opposite question to its second: only 69 percent of men in England with high-risk or locally advanced disease received radical treatment within twelve months, 12,333 of 17,966, ranging from 46 to 87 percent between teams.

    Sources: NICE NG131 recommendations: multiparametric MRI first line reported on a 5-point Likert scale (1.2.2), MRI-influenced biopsy at Likert 3 or more (1.2.3), the Cambridge Prognostic Group table (1.2.15), treatment by risk group (1.3.8 to 1.3.12), the active surveillance protocol (1.3.14), 60 Gy in 20 fractions (1.3.19) and the follow-up PSA intervals (1.3.47) (2021-12-15); Dearnaley D and others. Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial. Lancet Oncology 2016;17:1047-1060 (PMID 27339115) (2016-08-01); NHS England clinical commissioning policy 2106: stereotactic ablative radiotherapy for localised prostate cancer (adults), published 15 June 2026. SABR is now routinely commissioned as an alternative to moderately hypofractionated external beam radiotherapy for low and intermediate risk localised disease in men who do not need androgen deprivation therapy, at 36.25 Gy in five fractions, on the PACE-B criteria. It replaces the 2016 policy and asks for at least two subspecialist clinical oncologists with prostate SABR experience and radiotherapy trials quality assurance compliance before a centre may offer it (2026-06-15); NHS England: the NHS is to offer multi-beam precision radiotherapy to thousands with prostate cancer (10 June 2026), which says around 17,500 men a year in England are diagnosed with low or intermediate risk disease, that modelling suggests around 3,500 a year will choose stereotactic ablative radiotherapy, and that it is expected to be offered at all 48 radiotherapy providers in England. The page answers HTTP 202 to automated readers; National Prostate Cancer Audit: State of the Nation Report 2025, full report. 58,218 men diagnosed in England in 2024, up 9 percent on 2023; 9,590 radical prostatectomies and 20,782 radical radiotherapy courses in 2024; the eight performance indicators with their provider ranges; and the data completeness figures (2025-10); NHS England clinical commissioning policy B14/P/a: robotic-assisted surgical procedures for prostate cancer, October 2015. Robotic surgery is commissioned from networked centres undertaking at least 150 robot-assisted laparoscopic radical prostatectomies a year, with a recognised training programme and participation in the national audit. Its own stated review date was April 2017 and no successor policy could be found (2015-10)

13. 13
    Hormone therapy, its side effects and the bone rule most people get wrongConsider intermittent androgen deprivation therapy for long-term use, with PSA every 3 months and restart at 10 nanograms per millilitre (NG131 1.4.1 and 1.4.2). Offer supervised resistance and aerobic exercise at least twice a week for 12 weeks (1.4.19)

    NG131 devotes a whole section to living on androgen deprivation therapy rather than to the drug itself. Hot flushes: medroxyprogesterone 20 mg a day for ten weeks first, cyproterone acetate 50 mg twice a day for four weeks if that fails. Gynaecomastia from long-term bicalutamide: prophylactic radiotherapy to both breast buds within the first month, a single fraction of 8 Gy. Fatigue: tell people it is a side effect of the treatment and not necessarily the cancer, and offer supervised exercise twice a week for twelve weeks. Sexual function: phosphodiesterase type 5 inhibitors, then vacuum devices, intraurethral inserts, injections or prostheses, and a route to psychosexual counselling. The bone recommendations are four separate ones and are easy to run together. Do not routinely offer bisphosphonates to prevent osteoporosis in men on androgen deprivation therapy (1.4.12); do consider assessing fracture risk (1.4.13); do offer bisphosphonates to men on androgen deprivation therapy who have osteoporosis (1.4.14), with denosumab if bisphosphonates are contraindicated or not tolerated (1.4.15). Separately, do not offer bisphosphonates to prevent bone metastases (1.3.35), and in hormone-relapsed metastatic disease consider zoledronic acid to prevent skeletal-related events (1.5.19) and bisphosphonates for pain when analgesics and palliative radiotherapy have not worked (1.5.20).

    Sources: NICE NG131 recommendations: multiparametric MRI first line reported on a 5-point Likert scale (1.2.2), MRI-influenced biopsy at Likert 3 or more (1.2.3), the Cambridge Prognostic Group table (1.2.15), treatment by risk group (1.3.8 to 1.3.12), the active surveillance protocol (1.3.14), 60 Gy in 20 fractions (1.3.19) and the follow-up PSA intervals (1.3.47) (2021-12-15)

14. 14
    Follow-up, and what a rising PSA does and does not meanCheck PSA no earlier than 6 weeks after radical treatment, at least every 6 months for the first 2 years, then at least once a year (NG131 1.3.47). Consider remote follow-up after at least 6 months if the PSA is stable (1.3.49)

    NG131 is unusually restrained about biochemical relapse and this is the part of the guideline a man is most likely to need. Recommendation 1.3.55 says a rising PSA alone should not mean an immediate change in treatment. Recommendation 1.3.56 says estimate the PSA doubling time from a minimum of three measurements over at least six months. Recommendation 1.3.59 says do not routinely offer hormonal therapy for biochemical relapse unless there is symptomatic local progression, proven metastases, or a PSA doubling time of less than three months. Recommendation 1.3.57 offers radical radiotherapy to the prostatic bed after prostatectomy where there are no known metastases, and 1.3.54 says do not offer routine MRI before salvage radiotherapy, but do offer an isotope bone scan if symptoms or the PSA trend suggest metastases. Recommendation 1.3.48 says do not routinely do a digital rectal examination in localised disease while the PSA is at baseline.

    Sources: NICE NG131 recommendations: multiparametric MRI first line reported on a 5-point Likert scale (1.2.2), MRI-influenced biopsy at Likert 3 or more (1.2.3), the Cambridge Prognostic Group table (1.2.15), treatment by risk group (1.3.8 to 1.3.12), the active surveillance protocol (1.3.14), 60 Gy in 20 fractions (1.3.19) and the follow-up PSA intervals (1.3.47) (2021-12-15)

15. 15
    Hormone-relapsed disease, which NICE does not call castration-resistantDiscuss treatment options for hormone-relapsed disease at the urological cancer multidisciplinary team and seek an oncologist or specialist palliative care opinion (NG131 1.5.11). Offer docetaxel within 12 weeks of starting androgen deprivation therapy in newly diagnosed metastatic disease (1.5.6)

    NICE's heading throughout NG131 is hormone-relapsed rather than castration-resistant; the two terms mean the same thing and the older one is still used everywhere else, including on the drug labels. The funding table below sets out what is available by line. Two things about the British version of this pathway are distinctive. First, upfront docetaxel for newly diagnosed metastatic disease came from STAMPEDE and was commissioned by NHS England through a policy statement in January 2016, not through a technology appraisal; NG131 carries it as recommendations 1.5.6 and 1.3.26. Second, the audit finds the largest inequity on the page here, and it is by age. Among men in England with newly diagnosed hormone-sensitive metastatic disease, 66 percent of those under 75 received systemic treatment intensification within twelve months, 1,803 of 2,728, ranging from 39 to 87 percent between teams; among men aged 75 and over it was 29 percent, 867 of 2,951, ranging from 11 to 57 percent. Overall only 47 percent of English men received intensification. The audit's third recommendation asks providers to use individualised assessment such as a comprehensive geriatric assessment and not to deny investigation or treatment on chronological age alone.

    Sources: NICE NG131 recommendations: multiparametric MRI first line reported on a 5-point Likert scale (1.2.2), MRI-influenced biopsy at Likert 3 or more (1.2.3), the Cambridge Prognostic Group table (1.2.15), treatment by risk group (1.3.8 to 1.3.12), the active surveillance protocol (1.3.14), 60 Gy in 20 fractions (1.3.19) and the follow-up PSA intervals (1.3.47) (2021-12-15); National Prostate Cancer Audit: State of the Nation Report 2025, full report. 58,218 men diagnosed in England in 2024, up 9 percent on 2023; 9,590 radical prostatectomies and 20,782 radical radiotherapy courses in 2024; the eight performance indicators with their provider ranges; and the data completeness figures (2025-10); NHS England clinical commissioning policy statement: docetaxel with androgen deprivation therapy for hormone-naive metastatic prostate cancer (22 January 2016), the commissioning route that put the STAMPEDE docetaxel result into practice without a technology appraisal (2016-01-22)

16. 16
    What the treatment does afterwards, and who is meant to fix itOffer access to specialist erectile dysfunction services and to specialist continence services after radical treatment (NG131 1.3.36 and 1.3.39). NICE quality standard QS91 statement 4: people with adverse effects of prostate cancer treatment are referred to specialist services

    The audit added a new indicator for 2025 and it is the one that tells a man what the next two years may hold. Within two years of radical prostatectomy, 6 percent of men in England needed a procedural or surgical intervention for a genitourinary complication, 395 of 6,357, ranging from 0 to 21 percent between providers. Within two years of radical radiotherapy, 8 percent had a large bowel procedure with a diagnosis indicating radiation toxicity, 1,092 of 13,329, ranging from 0 to 16 percent, and 6 percent needed an intervention for a genitourinary complication, 752 of 13,364, ranging from 2 to 17 percent. Twelve percent of men had an emergency readmission within 90 days of radical prostatectomy, 1,060 of 8,868, ranging from 5 to 25 percent. NG131 sets out what should happen: specialist erectile dysfunction services, phosphodiesterase type 5 inhibitors and then vacuum devices, intraurethral inserts, injections or a prosthesis; specialist continence services with pelvic floor re-education and bladder retraining, and referral to a specialist surgeon for an artificial urinary sphincter in intractable stress incontinence, with bulking agents explicitly not offered. For radiation-induced enteropathy it asks for a team with expertise in it, and for full investigation including flexible sigmoidoscopy. QS91 statement 4 makes the referral itself the quality measure. The audit's second recommendation asks providers to review their variation and to make sure onward referral to those services actually happens.

    Sources: National Prostate Cancer Audit: State of the Nation Report 2025, full report. 58,218 men diagnosed in England in 2024, up 9 percent on 2023; 9,590 radical prostatectomies and 20,782 radical radiotherapy courses in 2024; the eight performance indicators with their provider ranges; and the data completeness figures (2025-10); NICE NG131 recommendations: multiparametric MRI first line reported on a 5-point Likert scale (1.2.2), MRI-influenced biopsy at Likert 3 or more (1.2.3), the Cambridge Prognostic Group table (1.2.15), treatment by risk group (1.3.8 to 1.3.12), the active surveillance protocol (1.3.14), 60 Gy in 20 fractions (1.3.19) and the follow-up PSA intervals (1.3.47) (2021-12-15); NICE QS91: prostate cancer, quality standard, five statements (published 11 June 2015, last updated 30 December 2021) (2021-12-30)

The NHS position of every approved product is on the NHS coverage page; the same decisions by country are on HTA decisions.

Match a report to targets and drugs on the biomarker matrix.

Prostate Cancer UK

Charity

• Specialist Nurses on 0800 074 8383, by telephone, WhatsApp, email and online chat, Monday, Tuesday, Thursday and Friday 9 to 5 and Wednesday 10 to 5
• A separate Risk Information Service on 0800 448 0821 for men who have not been diagnosed and want to talk through their risk and the PSA test
• A 30-second online risk checker, which the charity says more than 190,000 Black men have completed
• The Stronger Knowing More campaign for Black men, and a one-to-one peer support service matching a man with a trained Black volunteer who has had prostate cancer
• Information on every stage from a raised PSA to advanced disease, an online community, and nurse-led webinars on living with hormone therapy
• Co-funder and co-sponsor of TRANSFORM, the trial that will decide whether Britain screens

Open →

Cancer Research UK

Charity

• Freephone nurse helpline on 0808 800 40 40, Monday to Friday 9 to 5
• Plain-English information on prostate cancer and a clinical trial database
• The UK statistics quoted on this page
• It designed the screening committee's own infographic on what screening would do to 1,000 men, and it supported the committee's 2026 recommendation in the consultation

Open →

Macmillan Cancer Support

Charity

• Support line on 0808 808 00 00, 8am to 8pm every day, with online chat
• Separate information for early, locally advanced and advanced prostate cancer, and an online community prostate forum
• Money and benefits advisers on the same number, Monday to Friday
• Note that Macmillan Grants are no longer available nationally: the page now lists the local areas where they survive and directs everyone else to its money advisers and benefits calculator

Open →

Maggie's

Charity

• Centres across the UK beside major cancer hospitals, plus online support; support line 0300 123 1801
• Free, with no appointment and no referral needed
• One-to-one support with a psychologist, a benefits adviser or a cancer support specialist, and courses and groups in centres and online

Open →

Tackle Prostate Cancer

Charity

• The federation of local prostate cancer support groups across the UK, registered as the National Federation of Prostate Cancer Support Groups
• Patient-led: the groups are run by men who have had the disease
• Make Sense of It, a one-to-one treatment decision support service pairing a newly diagnosed man, or his partner, with a trained decision buddy

Open →

Prostate Scotland and Prostate Cancer Research

Charity

• Prostate Scotland: information and support for men in Scotland, including which urology units do what; it opposed the screening committee's 2026 draft recommendation in the consultation
• Prostate Cancer Research: funds research into advanced disease, runs The Infopool patient site, and leads Prostate Progress, the programme NHS England began inviting 500,000 men to join on 1 August 2026

Open →

NHS prostate cancer information and the PSA test

NHS

• Symptoms, causes, tests and treatment on nhs.uk, reviewed 31 July 2025
• The PSA test page, which is where the withdrawn Prostate Cancer Risk Management Programme addresses now redirect, with the preparation rules and what the result does and does not mean
• It states plainly that routine PSA testing is not offered on the NHS unless genetic tests have shown a faulty BRCA2 gene, and that anyone with a prostate can ask a GP about the test

Open →

Free NHS prescriptions in England (medical exemption certificate)

Cost and benefit

• Anyone being treated for cancer, the effects of cancer or the effects of cancer treatment is entitled to a medical exemption certificate, valid five years for cancer; ask the hospital or GP for form FP92A
• Everyone aged 60 and over is exempt anyway, which covers most men with prostate cancer

Open →

Prescriptions in Scotland, Wales and Northern Ireland

Cost and benefit

• Scotland: free for everyone since 2011, with no certificate needed
• Wales: free for anyone registered with a Welsh GP since 2007
• Northern Ireland: all prescriptions dispensed there have been free since 2010

Open →

Personal Independence Payment and Attendance Allowance

Cost and benefit

• Non-means-tested payments for people whose illness or treatment affects daily living or mobility: Personal Independence Payment under State Pension age, Attendance Allowance over it
• In Scotland these are Adult Disability Payment and Pension Age Disability Payment
• Incontinence, fatigue on hormone therapy and the effects of pelvic radiotherapy are exactly the kinds of daily-living difficulty these are meant for, and men under-claim them

Open →

Special rules for end of life (SR1)

Cost and benefit

• If a doctor, consultant or specialist nurse says you may have 12 months or less to live, claims for Personal Independence Payment, Universal Credit, Employment and Support Allowance and Attendance Allowance are fast-tracked at the higher rate with no assessment
• The SR1 form replaced the DS1500; the clinician completes and usually submits it

Open →

Healthcare Travel Costs Scheme

Cost and benefit

• Help with fares to hospital for people on qualifying benefits or a low income
• It matters here because radical prostate radiotherapy is 20 visits over four weeks on the standard schedule, and because Northern Ireland has two radiotherapy centres and Wales two

Open →

More schemes by country on Assistance; costs of care on Costs.

• Every HTML page on england.nhs.uk answers HTTP 202 with an empty Amazon Web Services firewall challenge body to automated readers: the National Genomic Test Directory page, the Cancer Drugs Fund list page, the cancer waiting times pages, the stereotactic ablative radiotherapy announcement and the Prostate Progress announcement. The files those pages link to, under wp-content/uploads, do resolve, and so does the site's content interface, which is how the current filenames were found. The content on this page is sound, but a reader following one of those links in a script will see nothing. The statistics subsite has its own content interface at england.nhs.uk/statistics/wp-json, which the main one does not index.
• Wales publishes no prostate or urological waiting-time figure that could be read. The monthly NHS activity and performance summary reports all cancers together; StatsWales has migrated to stats.gov.wales, where the cancer waiting times dataset does carry a tumour-site dimension but offers no comma-separated or interface download route that resolved, and the legacy open data host no longer answers at all. Northern Ireland publishes no 62-day split by tumour site, and its urological 31-day figure groups prostate with bladder, kidney and testis.
• England's 62-day prostate figure of 68.2 percent and Scotland's of 39.8 percent are not directly comparable and should not be read as a league table. England stops the 62-day clock for men in the lower Cambridge Prognostic Groups at the point active monitoring is agreed, counting that as a first treatment. Whether Scotland or Wales do the same could not be established: neither publication mentions active monitoring or surveillance anywhere, and the Scottish Government's clinical review of the waiting-time standards does not define first treatment at that level.
• Cancer Research UK has moved most of its rate-level breakdowns into interactive data hubs that serve no figures to an automated reader, so no age-standardised incidence or mortality rate per 100,000 for UK prostate cancer could be read from a CRUK page, and no one-year survival figure is published there at all. The incidence and mortality counts, the survival figures and the deprivation splits quoted here are the ones CRUK still prints in the served HTML. The age-standardised rates for Black and White men on this page come from the Department of Health and Social Care's equality impact assessment instead.
• There is no four-way stage split at diagnosis for prostate cancer in England on any page that could be read. CRUK publishes only an early-stage aggregate, 53 percent of staged cases in 2022, and the nearest verified proxy for advanced disease is the audit's metastatic-at-diagnosis indicator, 12 percent, which is an M1 measure and not a TNM stage 4 measure. Both sit on top of staging that is only 70 percent complete in England, with a provider range from 6 to 96 percent, so every English stage percentage is a percentage of a subset.
• The National Prostate Cancer Audit publishes no active surveillance uptake figure. It measures surveillance inversely, through the proportion of CPG 1 men who receive radical treatment, and there is no published number for how many men are on active surveillance at any time. It also publishes no time-to-treatment indicator and no patient-reported outcomes in the 2025 report, and no biomarker testing rates, so there is no figure for what proportion of men with hormone-relapsed metastatic disease are tested for BRCA1 and BRCA2. The 2026 State of the Nation patient and public report carries a publication date of 8 October 2026 and had no document attached on the check date.
• The audit publishes no other-cause mortality by ethnicity or deprivation, which is the figure that would settle whether the gap between Black and White men closes under equal access. Its indicators are all process or complication measures; ethnicity appears nowhere in the 2025 State of the Nation report's published indicator tables.
• Two national minimum-volume standards for prostate surgery are both live and they disagree. NHS England service specification 170114S of February 2019 asks for at least 100 cases a centre and 25 a surgeon; clinical commissioning policy B14/P/a of October 2015 asks for at least 150 robot-assisted laparoscopic radical prostatectomies a year, gave itself a review date of April 2017 and has no published successor; GIRFT's urology report of July 2018 proposed 40 a centre and 20 a surgeon while doubting the premise. Neither NHS England document names a single centre. The British Association of Urological Surgeons closed its radical prostatectomy data collection on 31 December 2019, so there is no current published surgeon-level or unit-level outcome data in the UK; the centre cards here are built from the national audit's workbook instead.
• NHS England expects prostate stereotactic ablative radiotherapy to be offered at all 48 English radiotherapy providers but has published no list of the 48, and the policy itself names no centre. Nor is there a published list of the centres that have completed the radiotherapy trials quality assurance step the policy requires before a centre may offer it, so a man cannot find out from a public page whether his centre can give him five fractions instead of twenty.
• NHS England's molecular radiotherapy service specification 2322 of September 2024 names no commissioned provider: section 7.8 contains a placeholder reading that the list will be added once available. So even for the radiopharmaceuticals the NHS does fund, such as radium-223, there is no public list of where they are given.
• The Institute of Cancer Research's researcher profile pages answer HTTP 403 with a JavaScript challenge to every automated request, and the site is mid-migration between two address schemes, so no icr.ac.uk profile is cited here. David Dearnaley, who led CHHiP, and Emma Hall, who is statistical lead on both CHHiP and PACE-B, have no readable public page and therefore no record on this page; the Royal Marsden consultant directory is cited for the clinicians who appear in both places.
• ISRCTN record pages answer HTTP 200 but serve a JavaScript cookie challenge rather than the record, so every trial here was read through the registry's public interface. The NIHR's Be Part of Research site returns HTTP 200 but renders in the browser only, so the three studies registered on ClinicalTrials.gov rather than ISRCTN (EvoPAR-PR02, IRONMAN and the Man Van project) are linked to a search page rather than to a record, and their details come from the registry entry read elsewhere. ELIPSE's registered recruitment window closed on 31 August 2026 and no update had been posted, so its row says to verify before travelling.
• The TRANSFORM funding figure has moved and neither version could be reconciled on a single page: the trial launched at around 42 million pounds, 26 million from Prostate Cancer UK and 16 million from the NIHR, and the charity's current page states 60 million after the government added up to 18 million more on 2 June 2026. No figure is quoted on this page for that reason. The four screening strategies the trial compares are not enumerated in the registry record either; they are described only in charity and press material.
• Cancer Drugs Fund list row ABI4, which funds upfront abiraterone in newly diagnosed high-risk metastatic hormone-sensitive disease from 13 December 2024, cites an NHS England commissioning policy proposition numbered 2424, and no published document with that reference could be located. The row also still carries no technology appraisal number, although TA1110 was published on 19 November 2025.
• NICE's condition-filtered product list for prostate cancer answered an error page or HTTP 403 to repeated requests with several header sets; the count of 79 products quoted here was read on one successful attempt at the unfiltered address. NICE Clinical Knowledge Summaries, which the Department of Health and Social Care has named as the replacement for the withdrawn risk management programme's GP guidance, answered HTTP 403 to every attempt, so what the NHS now tells GPs about PSA testing in Black men could not be read.