British researchers have made a major breakthrough that could pave the way for the first national screening programme for prostate cancer.
It will allow tumours to be found early and could ‘significantly’ reduce deaths from the disease, which kills around 10,000 men in the UK each year.
The NHS does not routinely screen for it as the best test available is unreliable.
Now researchers from the University of London have developed a screening method that more accurately estimates a person’s risk of developing prostate cancer.
It involves looking for raised levels of two biomarkers in a patient’s blood sample relative to their age.
Now researchers from the University of London have developed a screening method that more accurately estimates a person’s risk of developing prostate cancer (stock image)
Lead author Professor Sir Nicholas Wald said: ‘This approach could reduce false positive [tests] by three quarters, making screening safer and more accurate.’
The findings were published in the Journal of Medical Screening.
If the screening method is found to be successful in future studies it is hoped that it could one day be developed into a national screening programme.
There is no single test for prostate cancer but one of the first diagnostic tools used is a blood test that measures the amount of prostate specific antigen (PSA).
A raised PSA result can indicate a problem with a man’s prostate.
But the test isn’t offered to all men as there are both advantages and disadvantages of the test.
It has previously been suggested that screening on PSA levels alone could lead to more men needing a prostate biopsy – where a small sample of cells are collected for further examination – which can have side effects.
Others have raised concern about ‘overtreatment’ of a large number of men who have slow growing prostate cancer that would never have affected them during their lifetime.
The new study examined a new algorithm which examines a man’s levels of PSA and hK2 (human kalliknein peptidase) in the blood, as well as taking into account their age.
It involves looking for raised levels of two biomarkers in a patient’s blood sample relative to their age (stock image)
The paper examined how well the algorithm could predict prostate cancer by comparing blood samples of 571 men who later died after a prostate cancer diagnosis with the blood samples of 2,169 men never who were never diagnosed with the disease.
The authors from UCL, Queen Mary University of London and St George’s University of London, said combining the blood tests with a risk assessment tool could mean that 90% of cancers are detected with 1.2% of cases deemed ‘false positive’.
This method could help to reduce the number of false positive results by three quarters, the authors added.
Co-author Jonathan Bestwick, from Queen Mary University, said: ‘The approach is innovative for cancer, as it screens people on the basis of their overall risk rather than the results of a single test.
‘This is the same approach used in screening during pregnancy for certain foetal and maternal health conditions.’
There is no single test for prostate cancer but one of the first diagnostic tools used is a blood test that measures the amount of prostate specific antigen (PSA) (stock image)
Commenting on the study, Professor Roger Kirby, president of the Royal Society of Medicine and vice-president of the charity Prostate Cancer UK, said: ‘This is a novel approach which utilises the levels of two prostate cancer markers, PSA and hK2 (human kallikrein peptidase) to refine prostate cancer screening.
‘The use of PSA alone has significant drawbacks in terms of screening, but the addition of the hK2 marker in this context carries the genuine promise of significantly reducing the death rate from this most common cancer in men.’
Simon Grieveson, head of research at Prostate Cancer UK, added: ‘Catching prostate cancer early can save lives, but without a screening programme too many men will continue to be diagnosed too late.
‘Unfortunately, we currently do not have an accurate enough test to be used for a national screening programme and so it’s great to see promising research like this seeking to create a better test to detect prostate cancer early.
‘In the meantime, men can find out more about their risk by using Prostate Cancer UK’s risk checker, and should speak to their GP if they have any concerns.’
WHAT IS PROSTATE CANCER?
How many people does it kill?
More than 11,800 men a year – or one every 45 minutes – are killed by the disease in Britain, compared with about 11,400 women dying of breast cancer.
It means prostate cancer is behind only lung and bowel in terms of how many people it kills in Britain.
In the US, the disease kills 26,000 men each year.
Despite this, it receives less than half the research funding of breast cancer and treatments for the disease are trailing at least a decade behind.
How quickly does it develop?
Prostate cancer usually develops slowly, so there may be no signs someone has it for many years, according to the NHS.
If the cancer is at an early stage and not causing symptoms, a policy of ‘watchful waiting’ or ‘active surveillance’ may be adopted.
Some patients can be cured if the disease is treated in the early stages.
But if it diagnosed at a later stage, when it has spread, then it becomes terminal and treatment revolves around relieving symptoms.
Thousands of men are put off seeking a diagnosis because of the known side effects from treatment, including erectile dysfunction.
Tests and treatment
Tests for prostate cancer are haphazard, with accurate tools only just beginning to emerge.
There is no national prostate screening programme as for years the tests have been too inaccurate.
Doctors struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment.
Men over 50 are eligible for a ‘PSA’ blood test which gives doctors a rough idea of whether a patient is at risk.
But it is unreliable. Patients who get a positive result are usually given a biopsy which is also not foolproof.
Scientists are unsure as to what causes prostate cancer, but age, obesity and a lack of exercise are known risks.
Anyone with any concerns can speak to Prostate Cancer UK’s specialist nurses on 0800 074 8383 or visit prostatecanceruk.org