Prostate cancer is the most common cancer among men in the United Kingdom, with around 55,000 new cases diagnosed every year. Despite those numbers, it remains one of the least discussed, partly because it tends to develop slowly and often produces no noticeable symptoms in its early stages. For some men, it never causes problems at all. For others, it can be aggressive and life-threatening. The difference between those outcomes often comes down to how early it is detected.
The prostate is a small gland, roughly the size of a walnut, located just below the bladder. It surrounds the urethra, the tube through which urine passes out of the body. When cells in the gland begin to grow abnormally and without control, prostate cancer develops. Because the gland sits in close proximity to the urinary tract, problems with urination are often among the first signs something may be wrong.
Prostate cancer who is most at risk
One in eight men will develop prostate cancer at some point in their lifetime. For Black men, that risk is significantly higher, rising to approximately one in four. The disease is most common in men over 75, and cases in men under 50 are relatively rare. Having a close male relative, such as a father, brother, grandfather, or uncle, who has had prostate cancer also raises an individual’s risk. Around 12,200 men die from the disease each year in the UK alone.
Men who carry a variant of the BRCA2 gene, which plays a role in DNA repair, face an elevated risk as well. Mutations in this gene are associated with cancers that are more likely to develop and more difficult to treat.
Prostate cancer warning signs to watch for
Because prostate cancer often develops without symptoms, many cases are caught incidentally or during testing prompted by other concerns. When symptoms do appear, they typically involve changes to urination. These include needing to urinate more frequently, particularly during the night, difficulty starting to urinate, a weak or interrupted flow, and urine that takes an unusually long time to pass. Blood in the urine or in semen is a less common but important symptom that should always prompt a medical consultation.
None of these symptoms are exclusive to prostate cancer. They can be caused by other conditions, including benign prostate enlargement, which is far more common and not cancerous. But any persistent change in urinary patterns is worth discussing with a doctor, particularly for men in higher-risk groups.
How prostate cancer is tested and diagnosed
There is no single definitive test for prostate cancer. Diagnosis typically involves a combination of approaches. The prostate-specific antigen blood test, commonly known as the PSA test, measures a protein produced by the prostate. Elevated levels can indicate cancer, but they can also rise due to infection, inflammation, or benign enlargement, meaning a high result does not automatically signal cancer.
Men over 50 in the UK can request a PSA test from their doctor without a specific referral. Before the test, sexual activity and vigorous exercise, including cycling, should be avoided for two days, as both can temporarily raise PSA levels and affect accuracy. If PSA levels are elevated, further investigation typically includes an MRI scan and potentially a biopsy, in which a small sample of prostate tissue is examined in a laboratory.
The screening debate and what is changing
Prostate cancer is the most common cancer in the UK without a national screening programme. In May 2026, the government backed a recommendation that only a small and specific group of high-risk men should be offered regular testing. That group includes men with a BRCA2 gene variant combined with a family history of prostate, breast, ovarian, or pancreatic cancer. Those men are now recommended to receive PSA tests every two years between the ages of 45 and 61.
The screening committee determined that broader testing is likely to cause more harm than benefit, as it can miss aggressive cancers while detecting slow-growing ones that may never require treatment. Unnecessary treatment carries significant risks, including loss of bladder control.
A separate and significant development involves Black men, who face disproportionately higher risk but were not included in the general screening recommendation. The government announced investment in the TRANSFORM trial, through which all Black men aged 45 to 74 will be invited to participate in research aimed at developing better and more accurate testing methods for the disease.
Prostate cancer treatment options available
For men diagnosed with prostate cancer, treatment depends on how advanced the disease is and how quickly it is growing. Slow-growing cancers that are not causing symptoms may simply be monitored over time rather than treated immediately. When treatment is needed, surgery and radiotherapy can be curative in earlier stages. Hormone therapy is used to slow the growth of more advanced cancers. Additional options include cryotherapy, which uses extreme cold to destroy cancer cells, and high-intensity focused ultrasound. A doctor will advise on which approach is most appropriate based on the individual’s specific situation.
