MADRID: A groundbreaking 20-year study of over 160,000 men from seven European countries reveals that skipping prostate cancer screenings significantly increases the risk of dying from the disease — by as much as 45%.
Presented at the European Association of Urology Congress 2025, the research shines a spotlight on the often-overlooked group of screening non-attenders, who despite being invited for testing, choose not to participate.
Prostate cancer remains the most diagnosed cancer among men in 112 countries worldwide, and its prevalence is expected to double by 2040. Early detection is key — and this new data reinforces the importance of widespread participation in prostate-specific antigen (PSA) screening programs.
“We found that men who were invited for screening but chose not to attend were at a 39% higher risk of dying from prostate cancer compared to those not invited at all,” said Dr. Renée Leenen, lead author and researcher at Erasmus MC Cancer Institute, Netherlands.
The findings come from a secondary analysis of the European Randomized Study of Screening for Prostate Cancer (ERSPC) — the world’s largest and longest-running prostate cancer screening study.
Of over 72,000 men randomized to the screening arm, more than 12,400 (17%) did not attend any of the screening rounds. This group saw alarmingly higher death rates, prompting researchers to urge action to understand why men avoid screenings despite availability.
Why Are Men Skipping Screenings?
Avoiding screenings is not just a medical issue, but a behavioral and systemic challenge. Experts suggest a combination of lack of awareness, fear, misinformation, and inequality in access may be behind this trend.
Dr. Leenen emphasized the need for qualitative research to better understand these barriers:
“Tailored interventions are essential to address awareness, informed participation, and disparities in healthcare access.”
Screening Saves Lives – Up to 23% Lower Risk
According to Dr. Nilesh Vora, a leading oncologist not involved in the study, the data suggests that PSA screening reduces the mortality rate by up to 23% in men aged 55 to 69, who are prime candidates for curative treatment.
“We’ve long debated PSA screening, but this data highlights its critical role in saving lives,” said Dr. Vora.
WHO’s Benchmark: 70% Screening Coverage
To make a meaningful dent in mortality rates, the World Health Organization (WHO) recommends at least 70% participation in screening programs. However, many countries are falling short of this goal, with declining screening rates.
The bottom line? Boosting screening attendance can save thousands of lives. Policymakers, healthcare providers, and communities must work together to break down barriers and make screening more accessible and appealing to men at risk.
Conclusion:
This study provides compelling evidence that non-attendance in prostate cancer screenings isn't just a missed appointment — it's a potential life-threatening decision. With global prostate cancer rates rising, increasing awareness and access to PSA screening could be a turning point in men’s health outcomes.