Prostate cancer screening is associated with a risk of overdiagnosis of indolent disease and adverse effects associated with biopsy and overtreatment, leading to uncertainty around whether it can be cost effective.

Tailored screening according to a man’s predicted risks may improve the cost effectiveness of screening; however, robust evidence on the long-term effectiveness and cost effectiveness of these approaches is lacking.

This analysis has calibrated a natural history model using rich UK data from the Cluster Randomised Trial of PSA Testing for Prostate Cancer (CAP) and the Prostate Testing for Cancer and Treatment (ProtecT) trial to show that a once-off screen at age 50 years has the potential to be clinically effective and cost effective in a UK setting.