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• Men who avoided prostate cancer screening were significantly more likely to die from the disease, according to a large European trial.
• The reasons for ignoring screening are complex but may be related to a lack of education about the risks and benefits of prostate cancer screening.
• Prostate cancer is the second most common cancer in males after skin cancer.

Men who avoid prostate cancer screening face a significantly greater risk of dying from the disease, concludes a large European trial. Yet questions remain about why some males are hesitant to attend screenings and what can be done to encourage them.

Given the opportunity to screen for prostate cancer with a prostate-specific antigen (PSA) test, a significant number of males choose not to attend — a decision that may have serious health implications.

A new analysis of the European Randomized Study of Screening for Prostate Cancer (ERSPC), the world’s largest prostate cancer screening study, has identified this “screening avoidance” as a major mortality risk factor. 

The findings were presented at the European Association of Urology Congress 2025, March 21–24, in Madrid, Spain. The research has not yet been published in a peer-reviewed scientific journal.

Researchers performed a subanalysis of the massive study, which included the participation of more than 72,000 males invited for prostate cancer screening and 20 years of follow-up.

The results indicate that roughly 1 in 6 males (over 12,400) skipped all of their screening appointments, leading to a 45% higher risk of death from prostate cancer compared to those who did attend their screenings.

PSA testing has a long and sometimes contentious history as a screening method for prostate cancer that has led to serious debate about both its potential benefits and harms. However, newer research and other advancements in the field appear to be shifting the balance in favor of the benefits of prostate cancer screening.

“There’s good evidence that it prevents deaths. But the concern has always been that the side effects create an unclear balance of benefits to harms,” Robert Smith, PhD, senior vice president of Early Cancer Detection Science at the American Cancer Society, told Healthline. Smith wasn’t involved in the study.

“These findings, in a very large study with a very long-term follow-up, show a pretty dramatic benefit of screening,” he said.

Prostate cancer screenings lower death risk by 23%

Researchers from the Department of Urology, Erasmus MC Cancer Institute at the University Medical Center Rotterdam, The Netherlands, dubbed their analysis “The good, the bad, and the ugly,” as their findings identified benefits to PSA testing, but also significant barriers due to patient behavior.

Participants, consisting of males ages 55 to 69 years old, were randomized to one of two groups: those who were invited to attend screening appointments and those who were not (the control group).

Among the males invited to the screenings, a significant portion, dubbed “non-attenders,” skipped their screenings.

The so-called non-attenders were significantly more likely to die from prostate cancer than those who did attend. However, the findings get even more interesting compared to the control group.

Males who attended the screenings had a 23% lower risk of dying from prostate cancer compared to the control, while non-attenders had a 39% higher risk.

Furthermore, the benefits of screening are also likely understated due to the study design, which analyzed the entire group invited to screen, regardless of whether they actually attended. 

“Non-attenders can dilute the benefit of screening when the data is analyzed. It’s a downward drag on the outcome of those who are randomized to screening and actually show up in the first place,” said Geoffrey Sonn, MD, an associate professor of urology at Stanford Medicine who wasn’t affiliated with the research.

The flip side of this is that males who decline screening have a stark increase in risk of dying from prostate cancer compared to those who attend.

“This is the type of long term, randomized data that helps to put to rest the prior concerns that PSA testing may not be effective,” Jeffrey Tosoian, MD, MPH, an assistant professor of urology and director of Translational Cancer Research at Vanderbilt University Medical Center, told Healthline. Tosoian wasn’t involved in the study.

“Ultimately, the challenge lies in translating theoretical strategies into practice in a feasible and sustainable way to reach men across different populations and cultural and socioeconomic backgrounds,” lead study author Renée  Leenen, MD, a PhD candidate in urology at Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Urology, Rotterdam, The Netherlands, told Healthline.

Why do men skip prostate cancer screenings?

The reasons why men might skip prostate cancer screening are complex; they also fall outside the scope of the current research. However, experts interviewed by Healthline offered a range of reasonable possibilities.

“There may be something that’s just different about a person who’s involved in a trial and told to do one thing that just doesn’t come in to be seen. They may not take as good a care of themselves in general,” said Sonn.

That is, males who choose to skip a screening might be  “care avoidant,” opting to forego preventive care and other healthy behaviors.

Tosoian suggested that outdated or incorrect information about PSA testing could also be a factor in dissuading men from attending.

“Perhaps some heard years ago that PSA screening might not be helpful, and that really stuck with them, so they’ve never really looked into it again,” he said.

Leenen noted some of the most common barriers also include:

• Practical concerns, such as time and money to attend screening.
• Not understanding risks of prostate cancer.
• Lack of knowledge about screening (especially in younger males).

1 in 8 men will be diagnosed with prostate cancer

Prostate cancer is the second most common cancer in males after skin cancer. About 1 in 8 men will be diagnosed with prostate cancer during their lifetime.

Globally, there are roughly 1.4 million new prostate cancer cases yearly, but according to The Lancet Commission on Prostate Cancer, that number is expected to more than double to 2.9 million cases in 2040.

With cases surging, what strategies can be adopted to address the 1 in 6 males who actively choose to avoid screening?

“A big component of this is education and the need for the population to understand the risk that prostate cancer poses,” said Tosoian.

Although screening recommendations for prostate cancer are narrow compared to some other forms of cancer, males at average risk should consider one at age 50, and those with higher risk might consider screening as young as 40.

According to Leenen, the most important factor in getting men to attend screening is the social aspect.

If a friend or partner prompts a man about screening, they are more likely to investigate it. Having a loved one or family member with cancer may also encourage men to seek screening.

Leenen cited education on prostate cancer risks, doctor-recommended screening, and prioritizing self-care as potentially motivating factors.

“Of these, the role of partners is particularly important in men undergoing screening for prostate cancer,” Leenen said.

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• Seasonal allergies seem to last longer and be more severe in recent years than in the past.
• Health and environment groups point to the effects of climate change, such as longer growing seasons, as a possible reason for worsening seasonal allergies.
• There are actionable steps you can take to reduce your risk of exposure to pollen and other allergens.

As we bid farewell to peak cold and flu season, another wave of sniffles and sneezes is taking over, courtesy of spring allergies.

Seasonal allergies, which range from hay fever to allergic rhinitis and pollen allergies, seem to be arriving with greater intensity and lingering longer year after year. And no, you’re not imagining it.

In some parts of North America, allergy seasons have been extended up to three weeks.

Public health and research organizations like the Centers for Disease Control and Prevention (CDC) and the Asthma and Allergy Foundation of America point to climate change as a possible contributing factor to worsening allergy seasons.

With warmer air temperatures, pollinating plants may experience earlier and longer growing seasons, allowing them to produce more pollen.

“Climate change impacts allergy season because the consistent rhythm of, in the case of pollen, for example, new flowers being generated through Spring is all off kilter. Areas that were not pollinating at a given time are pollinating earlier, while other areas are pollinating later,” Frederic Bertley, PhD, president and CEO of the Center of Science and Industry (COSI), told Healthline.

“The trend we are seeing in recent years is an increase in allergic responses in individuals, generally speaking, and an increase in allergic responses by age,” he added.

More than a quarter of adults and about 1 in 5 children experience seasonal allergies in the United States.

All that coughing and wheezing comes with a price tag, too: current estimates put pollen-related medical expenses at more than $3 billion annually.

But, even with a worse allergy season, there are actionable strategies you can follow to decrease your pollen exposure and reduce your risk of allergies. Here’s your guide to staying sniffle-free and enjoying spring this year.

Lower your exposure to allergens in the home

Limiting your exposure to pollen is the best way to prevent symptoms during allergy season. This means keeping your home clear of pollen while you’re inside.

Keep pollen out

Close doors and windows during allergy season to physically keep pollen from entering your home.

“Sometimes that is frustrating because we like the breeze from opening a window, but the fact of the matter is that if you open a window, the pollen and other antigens/allergens will come in from the outside and be inside your home,” said Bertley.

Install HEPA filters

If possible, utilize HEPA filters on your HVAC system or air conditioning unit to keep pollen and other potential allergens such as mold out of your home. 

Spring clean

A little “spring cleaning” can go a long way to help reduce allergens in your home. “Try to keep as clean as possible and try to be as dust-free as possible,” said Bertley.

Take time to dust and clean the house: Dust and dander around the home are bound to contain pollen and other allergens.

If you’re a pet owner, it might be time to bathe your furry friend. Not only can pets trigger specific allergies from their dander, but they can also bring pollen into the home.

Wash your hands often

This one is a no-brainer for anyone who came away from cold and flu season unscathed.

Like viruses, pollen is likely to be on your hands. Washing your hands frequently can prevent it from getting to sensitive areas like your eyes, mouth, nose, and throat.

Limit pollen exposure when you’re outside

If you plan to be outside regularly or engage in outdoor activities during allergy season, your chances of exposure to pollen are higher. Still, you can take a few precautions to help limit your exposure to pollen.

Track pollen levels

Local and regional weather services regularly forecast pollen levels in the air. If you will be outside, track weather and pollen levels to limit exposure.

The Weather Channel provides a 15-day allergy forecast for tree, grass, and ragweed pollen.

Shower after being outdoors

If you’ve spent the day outside, your clothes will likely carry pollen back inside with you. Take a shower to remove pollen from your hair and body.

Consider washing your clothes immediately or storing them separately from other items to limit pollen spread.

If in doubt, don’t go out

If you have a severe allergic reaction to seasonal pollen, don’t risk going outside, especially if pollen levels are high.

“As much as we love Mother Nature, if you are very allergic to the things that Mother Nature provides, stay out of Mother Nature as best as possible until the season changes,” said Bertley.

Consider allergy medication

In addition to prevention, there are many options for allergy relief from your doctor and local pharmacy.

Over-the-counter allergy medications include:

• antihistamines
• decongestants
• nasal and oral corticosteroids

Stronger prescription versions of these types and of other drugs are also available through your doctor.

If spring allergies are preventing you from functioning normally, you should seek advice from your healthcare team.

For severe allergy symptoms, allergen immunotherapy or “allergy shots” could also be an option.

Allergy immunotherapy is a series of treatments in which an allergen is gradually introduced to the body to build up immunity to it.

What causes seasonal allergies?

While it is possible to experience pollen-related allergies throughout the year, they are most commonly associated with the seasons when specific plants are pollinating, leading to high levels of pollen in the air.

“Allergies occur as an abnormal response to something normally occurring in the environment, specifically protein fragments from tree pollen in the spring, grass pollen in the summer, and weeds in the winter,” Tania Elliott, MD, a spokesperson for the American College of Allergy, Asthma and Immunology, told Healthline.

Everyone responds to allergens differently, so you could be allergic to grass pollen but not tree pollen or ragweed. 

The term “hay fever,” or allergic rhinitis, refers to an allergic reaction to pollens released from trees, grasses, and other vegetation, which causes cold-like symptoms.

Some common symptoms of seasonal allergies include:

• sneezing
• runny or stuffy nose
• watery and itchy eyes
• itchy sinuses, throat, or ear canals
• ear congestion
• postnasal drainage

Takeaway

Seasonal allergies seem to last longer and be more severe than in years prior.

Experts believe climate change may affect seasonal allergies due to lengthening growing seasons.

You can take actionable steps to limit pollen exposure during allergy season. These include frequent handwashing, keeping doors and windows closed, checking daily pollen levels, and considering OTC or prescribed medications for relief.

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• A new study found that chewing gum releases hundreds to thousands of microplastics for every gram of gum.
• Both synthetic and natural gums were found to contain microplastics.
• While the long-term effects of exposure to microplastics are not well understood, emerging evidence has suggested several potential health harms.

Chewing gum can release hundreds to thousands of microplastics into the saliva that may be ingested.

Research presented this week at the spring meeting of the American Chemical Society in San Diego, CA, found that, on average, 100 microplastics were released per gram of chewing gum. The research has not yet been published in a peer-reviewed journal.

“Our goal is not to alarm anybody,” Sanjay Mohanty, PhD, the project’s principal investigator and an engineering professor at the University of California, Los Angeles (UCLA), said in a press statement.

“Scientists don’t know if microplastics are unsafe to us or not. There are no human trials. But we know we are exposed to plastics in everyday life, and that’s what we wanted to examine here.”

Past research estimates that an individual consumes between 39,000 and 52,000 particles of microplastics annually.

Microplastics are everywhere, and humans may be exposed to them through drinks, foods, plastic packaging, chopping boards, sponges, coatings on products, and the manufacturing process of items.

Chewing gum is one area that hasn’t been widely researched.

“My lab has done work mainly on microplastic transport in water and soil and their fate in soil. We learned different ways one can be exposed to microplastics: ingestion and inhalation,” Mohanty told Healthline.

“Most of the ingestion studies related to food are [about the] contamination of food with microplastic from plastic containers (e.g., plastic water bottles, plastic tea bags), but chewing gum is the only food that is made up of plastics. Yet, most don’t know. We wanted to measure microplastics in chewing gum. This is important to estimate total microplastic exposure into the human body and any possible negative effects,” Mohanty continued.

Chewing gum and microplastics exposure

Chewing gum is made with flavoring, sweetener, a rubber base, and other ingredients.

In chewing gums that are “natural,” a plant-based polymer, like tree sap, gives the gum chewiness. Synthetic rubber bases from a petroleum-based polymer (plastic) are used for synthetic gums.

The researchers examined five types of synthetic gum along with five types of natural gum that are commercially available.  

As part of the experiment, one person chewed seven pieces of gum from each brand to account for varied chewing patterns and saliva.

The person chewed the gum for four minutes and produced a saliva sample every 30 seconds. They then rinsed their mouth with clean water. The saliva samples were then combined into one sample.

In a different experiment, saliva samples were collected every 20 minutes.

The researchers then measured the amount of microplastics present in the saliva samples.

The researchers initially suspected that synthetic forms of chewing gum would contain more microplastics but were surprised to find natural chewing gums also contained a similar amount of microplastics.

“We were not surprised to find microplastics in chewing gum but we are surprised to find them equal amount in both synthetic and organic gum. We assumed organic one should have less than that of synthetic… We are perplexed by the source of microplastics in them (natural gums),” Mohanty said.

Microplastics found in synthetic and natural gums

The researchers found an average of 100 microplastics were released for every gram of gum.

Some pieces of gum produce up to 600 microplastics per gram. For context, the researchers note that a single piece of gum typically weighs 2–6 grams.

The researchers also found that both the synthetic and natural gums contained the same kind of polymers, the highest amount were of polyolefins, a type of plastic that includes polyethylene and polypropylene.

Tracey Woodruff, PhD, a professor of obstetrics and gynecology at UCSF who has studied the health impacts of microplastics, said the fact chewing gum contains microplastics isn’t entirely surprising. Woodruff wasn’t involved in the study.

“Nothing surprises me about how many places plastic is anymore, but it is sad and surprising in the fact that these things that are in our food or putting in our mouth, sometimes, for a long time, could be releasing microplastics,” she told Healthline.

“We already know we’re exposed to lots of different micro plastics… because they’ve been measured in every part of the body… But the problem is, is that the gum that you’re chewing is adding on to all the other microplastic exposure you’re already getting.”

Health impacts of microplastics

The health impacts of microplastics on humans are still the subject of ongoing research.

One 2024 review found that microplastics were suspected to harm human respiratory health, digestive health and reproductive health and were also possibly associated with colon and lung cancer.

Dana Hunnes, PhD, a senior clinical dietitian at UCLA Health, told Healthline that despite knowing that microplastics are widespread, the findings of the study are still shocking. Hunnes wasn’t involved in the study.

“I honestly never would have thought to even think about chewing gum as a source of microplastics! Yes, I am very surprised with this study, and not pleasantly so. When chewing gum, most people tend to swallow their saliva, so if chewing gum is releasing microplastics into saliva that people are swallowing, that’s not great,” she told Healthline.

Should you stop chewing gum?

Hunnes noted that some people may prefer to reduce their use of chewing gum or stop chewing gum altogether.

“This article indicated that both natural and manufactured chewing gums contained similar amounts of microplastics, so, in that case, it likely doesn’t much matter which they’re chewing. It might be best to stop or at least decrease the frequency. Especially for children [with] developing and more-susceptible brains to these chemicals causing damage,” Hunnes said.

Woodruff said chewing gum is a personal choice, but her own preference is to refrain from chewing gum.

“The more you chew, the more micro plastics you’re going to expose yourself to. And the other component of this is you’re adding plastics to already existing, ongoing plastic exposure. So my own preference would be to not chew chewing gum,” she said.

“If people are interested in lowering their exposures to microplastics, which we know are linked to certain types of health effects, not consuming chewing gum would be an option to avoid microplastic exposures.”

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