Hippo Labs has developed a set of indicators to help practices identify men at higher risk of prostate cancer and to track progress through the prostate cancer risk checking pathway.
These indicators are not clinical guidelines. Instead, they are a set of rules and measures designed to support recall, monitoring, and evaluation in general practice.
1. Building the High-Risk Register
At the heart of the process is a high-risk register of men who should be proactively invited. Patients are included if they are:
Male and aged 50–70, or
Male and aged 45–49 and either:
Black or Black-mixed ethnicity, or
Have a family history of prostate or breast cancer.
Patients are excluded if they:
No longer have a prostate,
Are on an end-of-life pathway,
Have declined screening,
Are newly registered in the past 3 months, or
This ensures the register reflects only those patients who are both at risk and suitable for proactive recall.
⚠️ October 2025 update: we are considering tightening the prostate cancer eligibility register to reflect the Prostate Cancer UK requirements i.e. including only men who are Black or have a family history of prostate or breast cancer across the whole age cohort. Men aged 50–70 without these risk factors may no longer be included. If you have any feedback, please let us know!
2. The Indicators
The indicators are designed to show both operational activity (recalls and invitations) and progress through the care pathway.
PCHR001 – Screening Invitations
The key operational indicator.
Identifies: Men who are on the risk register who haven't been diagnosed with Prostate Cancer previously or had a PSA test in the last 12 months.
Measures: The percentage of eligible men who have been sent a screening invitation in the past year.
Purpose: Drives the recall process.
Use this indicator to send messages to invite men to use the Prostate Cancer UK Risk Checker. You should use a screening invitation sent code like (710631000000102 - Prostate specific antigen monitoring invitation) to ensure this indicator gets marked as complete and that PCHR002 is triggered.
Note we're aware that the screening invitation codes are not quite right here but we recommend using this code as it's the closest we have to a 'risk checker invite sent' code and so we have used this to trigger the rest of the pathway.
PCHR002 – PSA Test Completion
Measures: The percentage of men recalled in PCHR001 who go on to have a PSA test in the past year.
Purpose: Tracks how many patients have been given a PSA test screening after an invitation to use the risk checker. Note we don't anticipate this should be 100% as not all patients using the risk checker will be advised that they are high risk and will not need to come back for a review.
PCHR003 – Referral Following PSA
Measures: The percentage of men with a PSA test who are referred for a 2-week wait urology appointment.
Purpose: Shows how often abnormal results are generated and then referred onwards.
PCHR004 – Prostate Cancer Prevalence
Measures: The percentage of men on the register who have a prostate cancer diagnosis.
Purpose: Provides a picture of disease burden in the high-risk population. If your screening programme has been effective, this should rise as more cancers are detected.
PCHR005 – Screening and Diagnosis Combined
Measures: The number of men who were both invited for screening and diagnosed with prostate cancer within the last year.
Purpose: Evaluates how effective the overall pathway has been in detecting cancers.
3. Putting It All Together
We recommend setting up a campaign for PCHR001 inviting patients to use the risk checker and then allowing that to cascade through into appointments when patients are advised by the risk checker to contact their GP.
Then you can use the remaining indicators to simply monitor the data on how many come in for a PSA test, how many are referred, and how many are ultimately diagnosed. This helps you to measure the overall impact of the programme.
4. Why This Matters
By using these indicators, practices can:
Ensure the right patients are identified and invited for risk checking.
Track how many risk check invites result in tests and referrals.
Understand how effective the pathway is at finding cancers.
Contribute to better, more equitable prostate cancer detection – particularly for men at higher risk.
✅ In short: The indicators help practices systematically identify and invite high-risk men, while also providing a framework to monitor outcomes and evaluate effectiveness across the whole pathway.