The College has submitted evidence to inform the development of a Men’s Health Strategy for England. 

Our evidence focused on the following areas:

• The pathology workforce
• Improving Men’s Health in Prostate Cancer
• Improving Men’s Health in Cardiovascular disease

The pathology workforce

The pathology workforce is in demand, and demand is rising faster than the growth in trained pathologists. Existing staff shortages are resulting in backlog, further compounding the perception and pressure of rising demand. Historical underfunding is compounded by increased extra resourcing of other medical specialties without consideration of the potential effects on pathology.

• NHS pathology services perform over 1.12 billion tests every year at a cost of £2.5 billion, representing 4% of total NHS spend - with demand estimated to increase 10% per year[1].
• Stronger focus on men’s health will expand the role of pathologists in diabetes, cancer and cardiovascular care. As outlined in the Men’s health strategy introduction, men are statistically more likely to develop type 2 diabetes earlier and experience complications like cardiovascular disease. However, they’re also less likely to engage with preventive healthcare services. As early detection and risk stratification strategies develop, this will represent an increased workload for pathologists.
• The pathology workforce has not increased to meet with anticipated increased workload and patient demand – the lack of pathology workforce is a severely limiting factor in addressing many of the issues impacting men’s health e.g. cancer screening, monitoring diabetes and cardiovascular health.

Ensuring pathology services can cope with current and future demand to meet with efforts to improve men’s health is vital to improve outcomes for men.

Improving Men’s Health in Prostate Cancer: A Histopathological Perspective

Prostate cancer remains one of the most common cancers affecting men globally, with significant variations in incidence and mortality. In the UK alone, over 52,000 men are diagnosed each year, making it the most commonly diagnosed male cancer. From a histopathological point of view, addressing this disease more effectively requires a balanced approach: increasing early and accurate diagnosis, improving treatment stratification, and crucially, avoiding the harms of overdiagnosis and the associated strain on pathology services.

The ethnic differences in prostate cancer mortality and morbidity are also a concern with a higher rate of diagnosis and high grade disease in black men.

Improving prostate cancer outcomes without triggering a wave of overdiagnosis requires nuanced use of histopathology. Pathologists are vital not only for diagnosis but for guiding risk-stratified management. Their workload must be respected and supported with staffing, technology, and training. A future of smarter screening, better biopsy strategies, and AI-augmented diagnosis holds promise—if implemented with care.

Improving Men’s Health in Cardiovascular disease

In the setting of cardiovascular disease, the key priorities to improving heart health are diabetes mellitus, obesity (diet) and hypertension. All of these represent avoidable or modifiable risk factors for coronary artery disease and heart failure.

Men are twice as likely as women to die prematurely from cardiovascular disease, lung cancer, liver disease and accidents. Although life expectancy is lower on average in poorer areas, deprivation has a greater impact on men: in the most deprived decile of local authorities, male life expectancy is 4.3 years shorter than female life expectancy, compared with 3.3 years in the least deprived decile. (King’s Fund determinants of health June 2024.)

Pathologists involved in heart disease both in the living and autopsy practice have told us that there is an increasing health burden driven by hypertension, diabetes mellitus and obesity which reduces life expectancy and productivity and places an increasing strain on the healthcare sector.

Whilst this extends across the adult population, the incidence of all these risk factors in total and on age adjusted basis is higher in men than women with a trend to an ever increasing early onset of disease and associated problems.

The incidence of all these risk factors in total and on age adjusted basis is higher in men than women with a trend to an ever increasing early onset of disease and associated problems.