Hundreds of UK men are trying out a new screening test for prostate cancer to see if it should eventually be offered routinely on the National Health Service (NHS), reports BBC News. The test is a non-invasive MRI scan that takes images of the inside of the body to check for any abnormal growths.
Scientists running the trial say it will take a few years to know if MRI will be better than available blood tests and biopsies at spotting cancers. NHS England said it would review this "potentially exciting" development.
The report says the UK currently doesn't offer routine screening because there is no reliable test. A blood test, called PSA, can check for high levels of a protein that can sometimes indicate that the person might have prostate cancer, but it is not always accurate. About three in four men with a raised PSA level will not have cancer and the test can also miss more than one in 10 cancers. Men with a raised PSA may need more checks, such as a biopsy.
MRI is non-invasive and, the report says, it might be a way to make prostate cancer testing more reliable and maybe even do away with the need for biopsies altogether, researchers hope.
A recent UK trial in men with high PSA levels showed more than a quarter could be spared invasive biopsies.
The report says the experts from University College London who are running the screening trial hope MRI will detect serious cancers earlier while reassuring the majority of men that they don't have cancer.
“I think that could revolutionise the way that we diagnose disease and hopefully identify men who would be better treated than not treated,” Professor Mark Emberton, the dean of medical sciences at University College London is quoted in The Guardian as saying.
Since prostate cancer grows slowly, it is possible that men with a negative scan at 55 or 60 years might effectively be given the all-clear for many years to come – or even for life. “If your prostate comes back looking very clean … you’re probably very unlikely to develop prostate cancer,” said Emberton. “It may be once we learn a bit more about it that you need to refresh it every 10 years or something like that.”
The report says the latest trial, funded by the Medical Research Council and Cancer Research UK, will invite 1,000 men aged 55 to 75 for scans through two London GP surgeries. The target is to scan 450, but how willing men will be to take up the offer is an open question. “We think they will,” said Emberton. “One of the reasons people didn’t before is because they were worried about the examination. You know, finger in the bottom. They were worried about the biopsy needle in the prostate. This involves neither.”
The report says the 10-minute scan, which it is estimated will cost about £150, is a simplified version of the 30-minute scan used to diagnose cancer in men who are at risk. The scientists are assessing the prevalence of prostate tumours in the population. It is anticipated that more than 90% of men should get a clean bill of health, with others being either referred for treatment or monitored over time.
Karen Stalbow, the head of policy, knowledge and impact at Prostate Cancer UK, said the trial could provide an exciting step towards a national screening programme. “If the results are positive, then MRI scanning could offer a non-invasive first stage of prostate cancer diagnosis in the future,” she said.
However, the report says, others cautioned that the reliability of MRI had not yet been established in the wider population. Professor Ros Eeles, professor of prostate cancer genetics at the Institute of Cancer Research in London, said: “The use of MRI of the prostate will be important in general management of prostate cancer assessment. However, currently it is not at all clear that MRI will be reliable to detect all cancers.
“In men at higher genetic risk, there are studies being undertaken at the Institute of Cancer Research to assess if men who have a genetic predisposition to aggressive prostate cancer have changes on their MRI when they get prostate cancer. At present, it is not at all certain that it will be reliable to rely on MRI alone for this assessment.”
[link url="https://www.bbc.com/news/health-48580037"]BBC News report[/link]
[link url="https://www.theguardian.com/society/2019/jun/09/mri-scans-to-be-trialled-as-test-for-prostate-cancer"]The Guardian report[/link]