LONDON, 02 May. - (ANA) - Prostate cancer screening could be on the horizon, thanks to a “game-changing trial” that aims to cut deaths from the disease by 40 per cent.

 

Researchers said the landmark study, which is about to get under way, was “the biggest, most exciting trial in prostate cancer screening and diagnosis” for more than two decades.

 

The mass trial will mix and match different methods of spotting the disease early, including high speed scans and gene tests, in order to establish which combination is most successful.

 

Scientists said the findings could pave the way for national screening strategies while providing a “treasure trove” of information to help fast-track treatment.

 

Prostate cancer is the most common cancer in men. Around 52,000 men in the UK are diagnosed annually and 12,000 die from the disease.

 

However, there is no screening programme, amid concern that existing tests are too unreliable, and would result in too many men undergoing needless treatment with harmful side effects.

 

The £42 million project, involving Imperial College London, University College London, Queen Mary University of London and the Institute of Cancer Research, will recruit more than 300,000 men aged 45 and over to test new methods.

 

 

 

 

Researchers said the new approaches had the potential to be twice as effective as screening methods that had previously been tested, with estimates they could reduce prostate cancer deaths by up to 40 per cent.

 

Scientists said the Transform trial, funded by Prostate Cancer UK, was a “game changer” because it would allow them to test so many combinations of factors, including genetic markers.

 

The first phase will involve about 12,500 men, who will be randomised to receive different combinations of Prostate Specific Antigen (PSA) blood tests, high-speed MRI scans (known as a Prostagram) and different types of genetic testing.

 

Men aged between 50 and 75, or from the age of 45 for black men, will be invited to take part in the trial by invitations from GPs next year. The first results are expected in as little as three years.

 

The trial’s second stage, involving up to 300,000 men, will test the most promising options from stage one of the trial, with patients tracked for at least a decade.

 

At least one in 10 patients who are invited to take part will be black, as black men carry double the risk of developing prostate cancer than other men.

 

 

 

 

Professor Hashim Ahmed, chair of urology at Imperial College London said: “This is by far the biggest, most exciting trial in prostate cancer screening and diagnosis in over 20 years.

 

“By evaluating fast MRI scans, PSA testing and genetics, we’ll finally be able to prove which is the best of the bunch when it comes to diagnosis. We will also see if they perform better in combination.

 

“By creating flexibility in the way we’ve designed the trial, we can incorporate promising new tests as they’re developed, future-proofing the study and making sure we design the best possible potential screening programme.”

 

Professor Ros Eeles, professor of oncogenetics at The Institute of Cancer Research, London and honorary consultant at The Royal Marsden NHS Foundation Trust, said the results could allow medics to identify the men most at risk of aggressive cancer, in need of regular checks.

 

She said: “We have already identified over 400 genetic variants that are inherited and are associated with a risk of prostate cancer in diverse populations.

 

“Transform is a game changer because it will allow us to rigorously test genetic markers on a large scale in men from diverse ancestries. This could give us the information we need to use genetic risk scores to identify men at risk of aggressive cancer who will need regular tests, while sparing men at low-risk unnecessary biopsies and treatments.”

 

 

 

 

Professor Mark Emberton, dean of UCL Faculty of Medical Sciences, said previous attempts at early detection of prostate cancer had used “very blunt” tools.

 

He said the combination of new advances, incorporating MRI, would allow scientists to establish which combination of tests worked best at identifying men with cancers that would impact on their quantity and quality of life if left untreated.

 

Currently, men over the age of 50, or 45 for black men, can request a prostate-specific antigen test.

 

Raised levels indicate an increased risk, and can lead to further tests, but are notoriously unreliable.

 

Around one in seven men with normal PSA levels will have prostate cancer that gets missed, while raised levels can result in action being taken to treat slow-growing cancer that would never have caused harm.

 

Dr Matthew Hobbs, director of research at Prostate Cancer UK, commissioned the screening trial, said: “Prostate cancer is the most common cancer without a screening programme and it’s about time we changed that.

 

“We know that earlier diagnosis saves lives, but previous trials haven’t been able to prove that enough men would be saved using PSA tests alone, while they did show that these old screening methods caused significant unnecessary harm to men. We must now prove that there are better ways to find aggressive prostate cancer that will save even more lives while causing less harm.

 

“That’s why I’m so delighted and proud to announce Transform. This is the research that will get us there.”

 

He said: “This could save thousands of men’s lives every year in the UK alone. But it won’t just be the UK – this trial could change practice globally – so we’re into tens of thousands of men saved each year.”

 

Researchers have worked with the UK National Screening Committee – which decides which programmes should be rolled out – the National Institute for Health and Care Research on the design of the trial, in the hope that findings can “revolutionise” prostate cancer diagnosis, the charity said.

 

Professor Rhian Gabe, professor of Biostatistics and Clinical Trials at Queen Mary University of London, said: “The UK has led the way in developing cancer screening programmes through rigorous, robust research. However, despite it being the second most common cause of cancer death in UK men, there still isn’t a screening programme for prostate cancer.

 

“Transform is an exciting opportunity to evaluate promising and innovative screening strategies for the early detection of prostate cancer on a national scale, with the ultimate aim of preventing deaths from prostate cancer.”

 

Andrew Stephenson, the health minister, said: “It’s fantastic to know that more people are surviving cancer in the UK than ever, but we know that’s partly down to early diagnosis.

 

“Screening for the most common cancer in men is complex but we’re backing groundbreaking trials like this to improve diagnostic processes and save thousands more lives.

 

“Alongside backing cutting-edge research, we are helping more people get diagnosed earlier for cancer and other conditions by rolling out additional tests, checks and scans at 160 locations across England through our community diagnostics centres programme.” -(ANA) -

 

AB/ANA/02 May 2024 - - -