With prostate cancer being one of the most common cancers affecting men globally, there is need for a multi-pronged approach to tackling a disease that affects 63,000+ men in the UK alone per year. The ethnic differences in prostate cancer mortality and morbidity are a concern. Black men face a higher rate of diagnosis and high grade disease (which means a tumour is likely to grow and spread faster).

Improving prostate cancer outcomes without triggering a wave of overdiagnosis requires a nuanced approach. The College supports the introduction, in the future, of smarter screening of high risk groups, better biopsy strategies, and AI-augmented diagnosis. These need to be implemented with care. Pathologists are vital for almost every aspect of patient care, from diagnostic testing and treatment advice to using cutting-edge genetic technologies and guiding risk-stratified management. Their workload must be respected and supported with staffing, technology, and training.

To truly improve men’s health without fuelling overdiagnosis we recommend:

• Focus screening efforts on high-risk groups, such as black men, those with BRCA1/2 mutations and those with a family history of the disease, rather than blanket screening.
• Implement MRI diagnostic pathways, ensuring biopsies are only taken when imaging suggests clinically significant disease.
• Invest in training and retaining histopathologists and expand the use of digital pathology to reduce bottlenecks.
• Use pathology data to refine prognostic models, incorporating histological, molecular, and imaging features to personalise treatment.
• Promote active surveillance for low-risk disease, relying on clear criteria and regular monitoring rather than immediate treatment.
• Encourage trials such as TRANSFORM to examine the utility of these newer techniques rather than blanket adoption.

Download our full position statement and briefing here: