On November 29, 2025, the debate over prostate cancer screening in the United Kingdom reached a fever pitch as actor Colin McFarlane, known for his roles in "Outlander" and "The Dark Knight," took to BBC Breakfast with an urgent appeal. His message was clear and heartfelt: black men, who face a much higher risk of prostate cancer, must step forward and participate in new research trials if the country is ever to see a screening program that truly works for everyone.
The catalyst for this passionate broadcast was the recent recommendation from the UK's National Screening Committee (NSC), a panel of doctors and economists, which advised against introducing widespread prostate cancer screening for most men. According to the NSC, mass screening is "likely to cause more harm than good." Their reasoning? The current blood test used for screening—called the PSA test—can miss dangerous cancers or, conversely, detect those that would never become a problem. These uncertainties, especially for black men, are compounded by a lack of robust clinical trials.
McFarlane, who was diagnosed with prostate cancer in 2022, spoke candidly about his own experience and the broader crisis facing men across the UK. "12,000 men a year die of prostate cancer, but 10,000 men a year are diagnosed too late for a cure. That's outrageous. That should not be happening in this day and age," he said, as reported by BBC News. He added, "Right now, the PSA is your best weapon." McFarlane himself undergoes blood tests every three months and an MRI scan annually as part of his ongoing monitoring.
The statistics are sobering. According to Prostate Cancer UK, one in eight men will be affected by prostate cancer during their lifetime. For black men, the odds are even more alarming: one in four will be diagnosed. This stark disparity has prompted McFarlane and advocacy groups to push for greater representation of black men in research, especially since, as the NSC noted, there are "uncertainties" about how screening might impact this group due to their underrepresentation in past clinical trials.
The NSC's recommendation did leave a narrow window open: screening should be considered for men aged 45 to 61 if they carry specific BRCA genetic mutations, which are linked to higher cancer risk. However, for the vast majority of men—including those at increased risk due to ethnicity—no routine screening is currently advised. The PSA test, coupled with follow-up scans and biopsies, is simply not accurate enough to justify mass use, the committee argued.
McFarlane was joined on BBC Breakfast by Chiara De Biase, a representative from Prostate Cancer UK. She echoed his disappointment, explaining that the charity had spent three years compiling and submitting scientific evidence in support of screening. "We are really disappointed about this. This has been three years in the making and we're actually the only organisation to submit the scientific evidence, because we think it was safe enough," De Biase stated. She emphasized the particular impact on the black community, saying, "We simply don't have sufficient evidence, particularly for black men who have been woefully underrepresented in research."
In response, Prostate Cancer UK is funding a new research initiative called the Transform trial. This study aims to find the safest, most accurate, and cost-effective way to screen men for prostate cancer. The trial is currently recruiting men aged 50 to 74, but for black men, the lower age limit is 45. The hope is that by increasing participation from high-risk groups, researchers can finally gather the data needed to support a future screening program that does more good than harm.
McFarlane's call to action was direct: "Any Black men listening to this, and you're between the age of 45 and 74, get hold of Prostate Cancer UK and go on their Transform programme to get this evidence that they say they're missing. Because that's really important." He also urged general practitioners (GPs) across the country not to dismiss men who request PSA tests, even if they show no symptoms. "When a man is brave enough to come into your surgery, please don't turn them away, please don't say you've got no pain, you've got no symptoms … we don't need to test you. I have no pain, I have no symptoms, but I do have prostate cancer. If you wait for pain and symptoms, it's spread," McFarlane pleaded on air.
His message resonated with viewers and underscored a deeper issue: mistrust of the healthcare system among black communities. McFarlane pointed to decades of suspicion, rooted in historical injustices like the Windrush scandal. "I think if you're looking at high-risk Black men, there's a lack of confidence with the NHS, because there's decades of mistrust with the establishment," he explained. He recounted a conversation with a businessman who had been refused a PSA test on three separate occasions, highlighting how systemic barriers can prevent early detection and treatment.
BBC Breakfast hosts Naga Munchetty and Charlie Stayt explored this further, asking whether a "lack of confidence or education" was discouraging men from seeking screening. McFarlane agreed, noting that in some black communities, there's a pervasive belief that "if you go into hospital you never come out again." He challenged this fatalism, urging a change in attitude and greater openness to preventive healthcare.
High-profile figures such as Sir Chris Hoy and Sir Stephen Fry, both of whom have publicly battled prostate cancer, have also voiced their opposition to the NSC's decision. Their advocacy, alongside McFarlane's, has kept the issue in the public eye and underscored the urgent need for better data and more inclusive research.
For now, the Transform trial represents the best hope for change. By recruiting a diverse group of participants, particularly those from high-risk backgrounds, researchers hope to answer the lingering questions that have stalled progress for years. The stakes couldn't be higher: thousands of lives could be saved if a safe and effective screening program is finally proven and adopted.
Prostate Cancer UK continues to encourage men—especially black men between the ages of 45 and 74—to participate in the Transform trial. More information and opportunities to contribute can be found at prostatecanceruk.org.
As the debate over screening continues, one thing is clear: early detection remains the key to saving lives. But until the science catches up with the needs of those most at risk, advocates like Colin McFarlane will keep pushing for change—one conversation, one trial, and one life at a time.
