New research highlights the potential of targeted prostate health checks for men at highest risk

A pioneering study led by researchers and clinicians in north east London has demonstrated that targeted prostate health checks for men at higher risk of prostate cancer are both feasible and could play an important role in improving early diagnosis while helping to tackle health inequalities.

The research, recently published in the BJGP Open journal, explored a new approach to identifying men who are more likely to develop prostate cancer, including Black men and those with a family history of the disease. The pilot was delivered across four Primary Care Networks in north east London through close collaboration between GP practices, Barts Health NHS Trust, Queen Mary University of London and North East London Cancer Alliance.

Unlike population-wide screening programmes, the Targeted Prostate Health Checks (TPHC) pilot focused on men aged 45 to 69 who are known to have a significantly higher risk of developing prostate cancer. The study examined different invitation methods and assessed how easily high-risk men could be identified through primary care records.

The findings showed that identifying high-risk men using age and ethnicity data held in GP records is achievable. Importantly, inviting men to have a prostate-specific antigen (PSA) blood test before their consultation ("test-first") resulted in significantly higher participation than asking them to attend an initial telephone consultation before testing. The research also highlighted opportunities to improve the recording of family history within primary care records, helping to identify even more men who could benefit from targeted health checks in the future.

The pilot also reinforced existing evidence that Black men continue to face inequalities in prostate cancer. Black participants were less likely to have previously undergone PSA testing and were more likely to live in areas of higher deprivation, demonstrating the importance of developing tailored approaches that improve awareness and access for communities at greatest risk.

Prostate cancer is now the most common cancer affecting men in England. While PSA testing can help identify prostate cancer earlier, it is not currently offered as a national screening programme because it can also detect slow-growing cancers that may never cause harm. Targeted approaches such as this aim to maximise the benefits of early detection while reducing unnecessary investigations and treatment.

Professor Prabhakar Rajan, Consultant Urological Surgeon at Barts Health NHS Trust, Professor of Urology and Robotic Surgery at Queen Mary University of London and senior author of the study, said:

"This study shows that targeted prostate health checks for men at higher prostate cancer risk can be delivered successfully through strong collaboration between primary and secondary care, and community partners. By focusing on those most likely to benefit from testing, we have an opportunity to diagnose prostate cancer earlier while addressing longstanding inequalities that affect Black men and those with a family history of the disease. Our findings also highlight the importance of improving how risk factors are recorded in primary care so we can identify and support even more men in the future."

The publication builds on a growing body of work led by Professor Rajan and colleagues to improve prostate cancer diagnosis and treatment in north east London. Earlier this year, the team also published guidance in the British Journal of Urology International (BJUI) outlining practical ways clinicians can better support men with early-stage prostate cancer, including helping patients make informed decisions between active surveillance and treatment based on their individual circumstances and preferences.

North East London Cancer Alliance continues to work with local NHS partners to improve awareness of prostate cancer, encourage informed conversations between men and their GPs, and reduce inequalities in cancer outcomes across the region.

Rishi Athwal, Project Manager for North East London Cancer Alliance, said:

"This research demonstrates the power of partnership working across north east London to develop innovative approaches that have the potential to improve cancer outcomes. By targeting support towards men at highest risk, we can help diagnose prostate cancer earlier, improve patient experience and ensure services are reaching the communities that need them most.

“We are working on a new project to raise awareness in men of their prostate cancer risk factor and how to take positive, proactive action when it comes to prostate cancer."

Professor Rajan will also be discussing the research, the latest advances in prostate cancer diagnosis and treatment, common myths and misconceptions, and what the future holds for prostate cancer care in an upcoming episode of the Taking Control of Cancer podcast, hosted by Steve Bland.

For more information

View our prostate cancer campaign pages: https://www.nelcanceralliance.nhs.uk/its-not-a-game 

Read about PSA tests: https://www.nelcanceralliance.nhs.uk/psa-tests 

Hear from a patient whose PSA test saved his life: https://www.nelcanceralliance.nhs.uk/news/little-kit-thing-saved-my-life