All links accessed on January 4, 2026

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2. Prostate Cancer UK. About prostate cancer. Last update December 2024 https://prostatecanceruk.org/prostate-information-and-support/risk-and-symptoms/about-prostate-cancer

3. Cancer Research UK. Prostate cancer statistics. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer

4. M Harris. Blog. ‘UK NSC opens consultation on draft prostate cancer screening recommendation’. UK National Screening Committee. November 28 2025. https://nationalscreening.blog.gov.uk/2025/11/28/uk-nsc-opens-consultation-on-draft-prostate-cancer-screening-recommendation/

5. Prost8. Enlarged prostate & BPH. https://www.prost8.org.uk/facts/enlarged-prostate-bph/

6. Cancer Research UK. Prostate cancer – Risks and causes of prostate cancer. Last reviewed September 11 2025. https://www.cancerresearchuk.org/about-cancer/prostate-cancer/risks-causes

7. Prostate Cancer UK. Home page.  https://prostatecanceruk.org/

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9. Prostate Cancer UK. Prostate cancer signs and symptoms. Last update December 2024. https://prostatecanceruk.org/prostate-information-and-support/risk-and-symptoms/prostate-cancer-signs-and-symptoms

10. SJS Sorensen et al. ‘Pesticides and prostate cancer incidence and mortality: An environment-wide association study’. Cancer. Published online November 4 2024. 131;1;e35572. https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.35572

11. Prostate Cancer UK. BRCA genes and prostate cancer risk. Updated October 2025. https://prostatecanceruk.org/prostate-information-and-support/risk-and-symptoms/are-you-at-risk/brca-genes-and-prostate-cancer-risk

12. I Gorodetska et al. ‘BRCA Genes: The Role in Genome Stability, Cancer Stemness and Therapy Resistance’. J Cancer. 2019. 10;9:2109-2127. https://www.jcancer.org/v10p2109.htm

13. Cancer Research UK. Stage types and grades – Types of prostate cancer. Last reviewed May 19 2025 https://www.cancerresearchuk.org/about-cancer/prostate-cancer/stages/types

14. Cancer Research UK. Prostate cancer – What is prostate cancer? Last reviewed May 2 2025. https://www.cancerresearchuk.org/about-cancer/prostate-cancer/about

15. L Jaouani et al. ‘Undifferentiated Sarcoma: A Rare Tumor of the Prostate’. Cureus. June 27 2023. 15;6:e41056. https://www.cureus.com/articles/165100-undifferentiated-sarcoma-a-rare-tumor-of-the-prostate#!/

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18. P Anamthathmakula et al. ‘Blocking serine protease activity prevents semenogelin degradation leading to hyperviscous semen in humans’. Biology of Reproduction. May 2022. 106;5:879–887. https://academic.oup.com/biolreprod/article/106/5/879/6517228

19. Cleveland Clinic. Skene’s Gland. Last reviewed September 2 2022. https://my.clevelandclinic.org/health/body/24089-skenes-gland

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21. Office for Health Improvement and Disparities. PSA testing and prostate cancer: advice for men without symptoms of prostate disease. Updated December 12 2024. https://www.gov.uk/government/publications/prostate-specific-antigen-testing-description-in-brief/psa-testing-and-prostate-cancer-advice-for-men-without-symptoms-of-prostate-disease-aged-50-and-over

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27. Michelle Roberts. ‘NHS to review prostate cancer testing after Chris Hoy call for change’. BBC News. November 5 2024. https://www.bbc.co.uk/news/articles/cpqde80r0g8o

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37. Prost8. Focal therapy. https://www.prost8.org.uk/facts/focal-therapy/

38. TJ Hoffman et al. ‘Genome-wide association study of prostate-specific antigen levels in 392,522 men identifies new loci and improves prediction across ancestry groups’. Nat Genet. 2025. 57:334–344. https://www.nature.com/articles/s41588-024-02068-z

39. Cancer Research UK. Hormone therapy for prostate cancer – What is hormone therapy for prostate cancer? Last reviewed July 4 2025. https://www.cancerresearchuk.org/about-cancer/prostate-cancer/treatment/hormone-therapy/about-hormone-therapy

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43. CL Vale et al. ‘Which patients with metastatic hormone-sensitive prostate cancer benefit from docetaxel: a systematic review and meta-analysis of individual participant data from randomised trials’. The Lancet Oncology. July 2023. 24;7:783 - 797. https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(23)00230-9/fulltext

44. Prostate Cancer UK. Hormone therapy. Update November 2024. https://prostatecanceruk.org/prostate-information-and-support/treatments/hormone-therapy

45. NICE BNF. Denosumab. https://bnf.nice.org.uk/drugs/denosumab/

46. Medicines and Healthcare products Regulatory Agency. Drug Safety Update ‘Denosumab (Xgeva▼, Prolia); intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk’. July 20 2015. https://www.gov.uk/drug-safety-update/denosumab-xgeva-prolia-intravenous-bisphosphonates-osteonecrosis-of-the-jaw-further-measures-to-minimise-risk

Appendices for online version

Appendix 1: Gleason scores

Gleason scores are used to indicate risk and disease grade. A Gleason score of 6 is low-risk grade 1 disease while a Gleason score of 8-10 is a grade 4-5 high risk cancer.²⁹

Appendix 2: Cambridge Prognostic Groups

The Cambridge Prognostic Score combines the Gleason score or grade, PSA level and T stage to assess PC that has not spread. It is not used for PC that has spread, which is treated as metastatic or advanced PC.^29,32