Prostate cancer screening as good as breast cancer screening, say researchers

(Press-News.org) Prostate cancer screening compares favourably to screening for breast cancer in identifying significant cancers, reducing mortality and avoiding unnecessary harms, says new research.

The findings are presented today [Sunday 15 March 2026] at the European Association of Urology Congress (EAU26) in London. The research is also accepted for publication in European Urology.

The researchers maintain that the similarities between the two forms of screening mean it is no longer rational to reject prostate cancer screening on one hand while endorsing screening for breast cancer on the other. Nevertheless, they recommend some caution given their research compares a trial with a population-based screening programme and across two different cancers.

Although breast and prostate cancer are the most commonly diagnosed cancers in Europe amongst men and women respectively, screening for the diseases is vastly different. Organised breast cancer screening programmes have been established across Europe for more than three decades. Prostate cancer screening has lagged behind, primarily due to concerns around the effectiveness of the PSA blood test and the risks of overdiagnosis and overtreatment. Nevertheless, many men undergo variable, ‘opportunistic’ screening for the disease, mostly based on self-referral.

Several prostate cancer screening trials in Europe have now reported long-term outcomes, showing a reduced risk of death from prostate cancer [1]. This risk reduction is similar to that seen in breast screening programmes.

The new analysis compares the two types of cancer screening in terms of the effectiveness of the diagnostic tests and levels of overdiagnosis. The researchers, from the German Cancer Research Centre in Heidelberg, Germany, drew on data from the PROBASE prostate cancer screening trial in Germany and the country’s breast cancer screening programme.

They used data from 39,392 men who underwent an initial PSA blood test as part of the PROBASE trial at age 45 or 50.  They compared this with data from just over 2.8 million women, aged 50–69, who had a mammography as part of Germany’s organised breast cancer screening programme. They found:

PSA blood testing followed by an MRI scan leads to a higher number of false positives than mammography (37-42% vs 10%). A similar proportion of men and women were referred for biopsy (0.8-2.4% for men and 1.1% for women) as men in the PROBASE trial were triaged before referral using various factors to determine the likelihood of significant cancer (known as risk stratification) Biopsies were far more likely to identify significant cancer in prostate screening than in breast screening (50-68% vs 10%), indicating that fewer men were referred for biopsy unnecessarily. The percentages of invasive cancers identified were similar across both prostate and breast cancer screening (60-74% vs 73%). Prostate cancer screening was more likely to identify non-aggressive cancers than breast cancer screening (26-31% vs. 22%). However, in prostate cancer the option of active surveillance is well-established, and the researchers maintain this would limit the risk of overtreatment. Active surveillance involves monitoring lower-grade cancers and only starting treatment (radiotherapy or surgery) if they progress. Dr Sigrid Carlsson, who leads Clinical Epidemiology of Early Cancer Detection at the German Cancer Research Centre (DKFZ) in Heidelberg, is lead author of the research. She said: “Until we have a population-based screening programme for prostate cancer, we can’t make an exact like-for-like comparison with breast cancer. But we can make some informed assumptions based on the data from our trial, which shows that if prostate cancer screening were extended to the wider population, then the outcomes are likely to be very similar to breast cancer. Although our study used German data, the findings are applicable to other countries. The final question we now need to answer is: what will this cost compared to what we are already paying for opportunistic screening? And that work is already underway.”

Tobias Nordström is a clinical urologist and Associate Professor at the Karolinska Institute, Sweden and a member of the EAU Scientific Congress Office. He said: “There is much that prostate cancer screening can learn from breast cancer screening and that is why this analysis is an important addition to our knowledge base. As these kinds of comparisons are very challenging, the results do need to be taken with a level of caution. That said, the clear overall similarities between the outcomes for breast and prostate cancer screening show that we are moving in the right direction, ensuring prostate cancer screening offers more benefits than harm.”

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