Prostate cancer affects approximately 8 000 men per year in Czechia, which represents a 7% higher incidence (165 per 100 000 population) than the EU averages (OECD and European Commission, 2025) , and approximately 1 400 men die from the disease annually (Euractiv, 2023). Around one-third of cases were reportedly detected at stage III or IV, and prior to the programme, unorganized opportunistic PSA testing was common, contributing to inefficient use in younger men (<50 years) and overdiagnosis in older men (>70 years) (Science Advice for Policy by European Academies (SAPEA), 2022).
The high proportion of late-stage diagnosis and the inefficient use of the PSA testing caught significant political attention, prompting the Czech Ministry of Health to initiate a new programme for more organized prostate cancer screening. Its development involved broad multi-stakeholder engagement, including a national roundtable in 2022 and the formal Committee for Preparation of the Prostate Cancer Early Detection Programme in 2023 (Science Advice for Policy by European Academies (SAPEA), 2022). Key stakeholders included the Czech Urological Society, the National Screening Centre (UZIS), the Institute of Biostatistics and Analyses at Masaryk University, the Society of General Practice, the Czech Society for Oncology, the Czech Radiological Society, health insurance companies, and patient organizations such as STK for Men. The programme aligns with the EU Council Recommendation on cancer screening of December 2022, the EU4Health-funded PRAISE-U project and the EUCanScreen Joint Action, hence also aligning with the broader objectives of Europe’s Beating Cancer Plan. The National Screening Centre and the Institute of Health Information and Statistics of the Czech Republic (UZIS) are responsible for the rollout of the screening programme.
Preparatory work began in 2022, including national health information system analysis, a small-scale pilot, and modelling of projected costs and outcomes. The full nationwide programme launched in January 2024, with enrolment offered through GPs and via urologists, targets men aged 50–69 without a prior prostate cancer diagnosis. Men with a PSA result of ≥3.0 µg/l undergo referral to a certified urologist for in-depth diagnostic assessment. The initial PSA test requires no special certification from the administering GP or urologist. Where further workup is clinically indicated, the urologist refers the patient to a Ministry of Health-accredited centre for MRI. This accreditation is specific to centres providing MRI and biopsy services for urologist-referred patients. If MRI results suggest tumour presence, a targeted biopsy is performed at a Ministry of Health-accredited centre. Monitoring draws on the National Health Information System (NHIS), the Czech National Cancer Registry (CNCR), the National Registry of Preventive and Screening Examinations (NRPSE), and the National Registry of Reimbursed Health Services (NRRHS), with a formal programme evaluation planned at the five-year mark.
Enablers: Multi-stakeholder governance infrastructure appears to have supported the programme’s development, with structured committee-led preparation and engagement across clinical, academic, and patient communities prior to launch (governance). Integration within existing primary care infrastructures, specifically biennial check-ups with GPs, appears to have facilitated broad population reach for initial enrolment without requiring a new access pathway (service delivery). Public health insurance reimbursement of the full screening pathway seems to have supported financial access for eligible men, removing cost as a barrier to participation (financing).
Barriers: Variable urologist involvement is noted, indicating that strengthening urologist engagement remains an ongoing challenge (resource generation). As the programme is still in its pilot phase, data on longer-term diagnostic and clinical outcomes are not yet available, which may limit the evidence base for further policy decisions (governance).
In the first 12 months, screening was offered to 150 498 men, with PSA results available for 146 109 (97.1%). Of those, 8.8% had PSA ≥3.0 µg/l. The two-year PSA testing coverage rate rose from 47.4% in 2023 to 53.3% in 2024, and pre-biopsy MRI use increased from 28.0% to 38.3% (a 10.3 percentage-point difference, 95% CI 8.3–12.2), indicating early movement toward improved quality of diagnostic pathway adherence (Koudelková et al., 2026). Even though the programme is at an early stage, the data on access and equity outcomes, including cancer detection rates and stage, suggest that the structured enrolment model appears to have the potential to reach men previously subject to inconsistent opportunistic testing.
Lessons learned: The integration within biennial primary care check-ups, although it is not formally required by the methodology, has evolved organically and appears to have been an effective enrolment mechanism, suggesting that leveraging existing service delivery structures may support population-level reach (service delivery). The programme seems to show the feasibility of transitioning from widespread opportunistic PSA testing to an organized, structured screening programme with improved adherence to guideline-based diagnostic pathways.
For more information
Koudelková, M. et al. (2026) “Implementation and first results of the Czech nationwide prostate cancer screening pilot programme.” medRxiv, p. 2026.01.05.26343424. Available at: https://doi.org/10.64898/2026.01.05.26343424 [preprint].
Májek, O. et al. (no date) “Information support for planning and evaluation of cancer screening in the Czech Republic”.
