Scientists say they have developed a prostate cancer scan accurate enough to potentially replace current invasive examination techniques and save thousands of lives each year.
Prostagram, developed by experts at Imperial College London, employs MRI scanning and is modelled on breast cancer screening, where women are routinely offered a mammogram scan every three years as part of a national programme.
A trial of 408 men, the results of which were published in Jama Oncology on Thursday, found that Prostagram detected approximately twice as many clinically significant cancers as the standard PSA (prostate specific antigen) blood test.
Previous MRI scans have had reliability issues but the Prostagram, which identified about 75% of aggressive prostate cancers in volunteers, is the first that is accurate enough to be considered for screening. The researchers say the trial results suggest the 15-minute scan could find an extra 40,000 cases of prostate cancer a year in the UK alone.
Prof Hashim Ahmed, senior author and chair of urology at Imperial College London, said: “Prostagram has the potential to form the basis of a fast, mobile national-screening programme for prostate cancer and could be a gamechanger. Prostagram also has the potential to detect more aggressive cancers earlier and pass over the many cancers which don’t need to be diagnosed. By finding these aggressive cancers at the earliest opportunity, men have the opportunity to be offered less invasive treatments with fewer side-effects.”
The number of prostate cancer deaths in the UK has overtaken the number of breast cancer deaths (approximately 12,000 compared with 11,000), with the national breast screening programme credited with saving an estimated 1,300 lives a year.
Last year, Prostate Cancer published research showing it is the most commonly diagnosed cancer in the UK, with 57,192 new cases in 2018.
PSA tests are not recommended for screening because they are unreliable and can yield false positive results, while digital rectal examinations (DREs) are invasive, which can put men off being tested, and also have issues with reliability.
A third of the men in the Prostagram trial were black, which is significant given their increased risk of prostate cancer. One in four black men in the UK will be diagnosed with prostate cancer in their lifetime compared with one in eight in the general UK population.
Dr David Eldred-Evans, another researcher and developer of the Prostagram, said: “Plans for a more extensive trial covering 20,000 men are well advanced and will proceed in the coming months subject to funding. If results from this study are similar or better than those revealed today, there is then a clear pathway to the widespread implementation of Prostagram into the general population.”
Funders of the research, which has been supported by Stephen Fry, include the Urology Foundation, the Wellcome Trust, the BMA foundation for Medical Research and the National Institute of Health Research Imperial Biomedical Research Centre.