On November 21, 2025, the United Kingdom embarked on what experts are calling a pivotal moment in men’s health: the launch of the £42 million Transform trial, the largest prostate cancer screening study in a generation. Invitations have begun landing on the doormats of eligible men across the country, marking the start of a nationwide effort that aims not only to revolutionize how prostate cancer is detected but also to save thousands of lives in the process.
Health Secretary Wes Streeting didn’t mince words, describing the Transform project as a “game-changer.” “Prostate cancer is one of the biggest killers of men in the UK. Devastatingly, around one in eight will get it, and that risk is doubled in Black men. But today marks a turning point for prostate cancer care in this country as the first men are invited to take part in this game-changing trial funded by the Government and Prostate Cancer UK,” he said, according to BBC and The Institute of Cancer Research.
The scale of the trial is unprecedented. In its first phase, 16,000 men aged between 50 and 74—or as young as 45 for certain high-risk groups, including Black men—will be recruited. The study is rigorously comparing several innovative screening techniques against the NHS’s existing approaches, which typically rely on blood tests for prostate-specific antigen (PSA) and biopsies. Now, however, the arsenal has been expanded: genetic saliva tests, rapid MRI scans (dubbed "prostagrams"), and advanced combinations of these methods are all on the table.
Professor Hashim Ahmed, chairman of urology at Imperial College Healthcare NHS Trust and chief investigator of the trial, captured the sense of urgency and hope: “Transform is truly game-changing… the start of recruitment today marks a pivotal step towards getting the results men urgently need to make prostate cancer diagnosis safe and more effective so that we can unlock the potential of prostate cancer screening in the UK.” He emphasized the need for better screening, stating, “Combining our world-class team of UK researchers, the latest screening techniques like fast MRI scans, PSA blood tests and genetic tests, we can find the best way to screen men for prostate cancer – minimising late diagnosis, saving more lives and doing so with fewer harms.”
Why the need for change? As it stands, there is no national prostate cancer screening programme in the UK. The main reason: the PSA test, while widely used, is notorious for its unreliability. It often picks up cancers that wouldn’t need treatment and, worryingly, misses aggressive cancers that do. According to Prostate Cancer UK, around 55,000 new cases are diagnosed each year, making it the most common cancer among UK men. Yet, current diagnostics don’t find enough aggressive cancers and can lead to unnecessary treatments that cause side effects like incontinence or impotence.
Matthew Hobbs, director of research at Prostate Cancer UK, highlighted the human cost: “We hear from men who were diagnosed late, whose lives may have been saved if they’d been screened or tested earlier. We also hear from a lot of men who have suffered incontinence or impotence because of treatments they had. Some of those men didn’t need to have those treatments, and that’s the harm that we need to try to avoid.”
The Transform trial aims to do better. The first testing site is up and running at the InHealth community diagnostic centre in Ealing, with more centres set to open across the UK. Men cannot volunteer for the trial; instead, they’re invited directly by their GPs, mirroring how a future screening programme might operate. Prostate Cancer UK is urging anyone who receives an invitation to consider taking part.
The study is also determined to tackle longstanding inequalities. Black men are twice as likely to develop and die from prostate cancer, yet they’ve been underrepresented in past research. To address this, at least one in ten men invited to participate will be Black, and the trial team is working closely with Black community leaders to ensure good representation. Professor Ros Eeles, a leading oncogenetics expert at The Institute of Cancer Research, explained, “TRANSFORM is a game changer because it will allow us to rigorously test genetic markers on a large scale in men from diverse ancestries. This could give us the information we need to use genetic risk scores to identify men at risk of aggressive cancer who will need regular tests, while sparing men at low-risk from having unnecessary biopsies and treatments.”
Laura Kerby, chief executive of Prostate Cancer UK, was effusive about the project’s potential: “The future of prostate cancer screening starts today. It’s incredible to see the launch of this once-in-a-generation trial that so many people have worked to make possible, from our scientists to our amazing supporters raising funds.” She added, “The men signing up for the study, and the people who donate to keep it running, will have the power to help save thousands of lives each year in the UK and even hundreds of thousands globally.”
The Transform trial is not just about testing new ways to diagnose prostate cancer—it’s about building a foundation for the future. The massive scale of the project will create the largest ever bank of prostate cancer samples, images, and data, powering the development of new tests and treatments for decades to come. The trial is co-led by six of the world’s leading prostate cancer researchers, including Professor Eeles, Professor Ahmed, Professor Mark Emberton, Professor Rhian Gabe, Professor Rakesh Heer, and Professor Caroline Moore, all working together to ensure the study’s rigor and reach.
Funding for Transform is equally ambitious. The National Institute for Health and Care Research (NIHR) has committed £16 million, with the remaining £26 million provided by Prostate Cancer UK and its founding partners, including the Cockburn Shaw Legacy, Freddie Green and Family Charitable Foundation, Garfield Weston Foundation, Movember, Omaze, and Paddy Power.
Patient voices are also central to the story. Steve Kavanagh, a 64-year-old from Hampshire who was diagnosed in 2023, shared his perspective: “My dad and a close friend both had prostate cancer, so I was always very aware of my risk and had regular PSA tests over the years. My level was higher than normal without being alarming, and when I was referred for more tests, at first they didn’t find anything. But when I was finally diagnosed, my consultant told me he thought the cancer could have been there for four years already and had been missed or was not visible in an earlier biopsy – it was found after a second scan and ‘targeted’ biopsy. That’s what makes TRANSFORM so important. It’s not just about giving everyone PSA tests, it’s about finding the best way to make sure that if you do have cancer, it isn’t missed.”
The trial’s timing is notable. Its launch comes just as the UK National Screening Committee (NSC)—the expert body that advises the NHS—is preparing to announce its decision on whether to recommend a national screening programme for prostate cancer. If the NSC finds the current evidence insufficient, early results from Transform, expected in about two years, could tip the scales.
Meanwhile, the government’s first men’s health strategy, announced earlier this week, is already recommending at-home PSA tests for easier monitoring, potentially rolling out from 2027 pending clinical validation. Prostate Cancer UK, however, urges caution, stressing that more work is needed before home PSA tests can be widely recommended.
As the Transform trial moves forward, it represents more than just a scientific milestone—it’s a bold attempt to rewrite the story of prostate cancer in the UK. With thousands of lives hanging in the balance, the hope is that this once-in-a-generation study will finally deliver the answers men and their families have been waiting for.
