Screening for prostate cancer compares favorably with screening for breast cancer in detecting major cancers, reducing mortality and avoiding unnecessary harm, new research reports.
The findings will be presented on March 15, 2026, at the European Congress of Urology (EAU26) in London. Research is also accepted for publication at European Urology.
The researchers argue that the similarities between the two forms of screening mean that it no longer makes sense to reject prostate cancer screening on the one hand while supporting breast cancer screening on the other. However, they recommend some caution since their research compared a trial with a population-based screening program in two different cancers.
Although breast and prostate cancer are the most commonly diagnosed cancers in Europe among men and women, respectively, screening for these diseases is very different. Organized breast cancer screening programs have been established across Europe for more than three decades. Screening for prostate cancer has been delayed, largely due to concerns about the effectiveness of the PSA blood test and the risks of overdiagnosis and overtreatment. However, 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 results, showing a reduced risk of death from prostate cancer. This risk reduction is similar to that seen in breast screening programs.
The new analysis compares the two types of cancer screening in terms of the effectiveness of diagnostic tests and levels of overdiagnosis. The researchers, from the German Cancer Research Center in Heidelberg, Germany, drew on data from the PROBASE prostate cancer screening trial in Germany and the country’s breast cancer screening program.
They used data from 39,392 men who had an initial PSA blood test as part of the PROBASE trial at age 45 or 50. They compared them with data from just 2.8 million women, aged 50–69, who had a mammogram as part of the organized breast cancer screening program in Germany. They found:
- PSA blood testing followed by MRI results in 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 tested before referral using various factors to determine the likelihood of significant cancer (known as risk stratification).
- Biopsies were much more likely to detect significant cancer in prostate screening than in breast screening (50-68% vs. 10%), indicating that fewer men were referred for biopsy without reason.
- The rates of invasive cancers detected were similar in both prostate and breast screening (60–74% vs. 73%).
- Prostate cancer screening was more likely to detect 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 argue that this would reduce the risk of overtreatment. Active surveillance involves watching for lower-grade cancers and starting treatment (radiotherapy or surgery) only if they progress.
Until we have a population-based screening program for prostate cancer, we cannot make an accurate comparison with breast cancer. But we can make some educated guesses based on the data from our trial, which shows that if prostate cancer screening is extended to the wider population, then the results are likely to be very similar to breast cancer. Although our study used German data, the findings apply to other countries as well. The final question we now have to answer is: what will this cost compared to what we already pay for opportunistic screening? And this work is already underway.”
Dr. Sigrid Carlsson, Lead Study Author and Head of Department, Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center
Tobias Nordström is a clinical urologist and associate professor at the Karolinska Institute, Sweden and member of the EAU Scientific Conference Bureau. 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 should be taken with caution. That said, the clear overall similarities between the results for breast and prostate cancer screening show that we are moving towards the right direction.
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