Monday June 10, 2019
By Henry Bodkin
A new one-off prostate cancer test at the age of 55 promises to give men “peace of mind” that they will never develop the disease, scientists have revealed.
The 10-minute scan, which could be rolled out in supermarkets and shopping centres, detects dangerous cancers years before they cause any harm while ignoring growths that do not pose a threat.
Subject to a government-funded trial beginning this summer, the new MRI (magnetic resonance imaging) technique should enable the world’s first universal screening programme for prostate cancer.
The disease currently kills more than 11,600 men in the UK each year.
All women in England are invited for a mammogram to check for breast cancer every three years from the age of 50 to 70.
47,300 Annual cases of prostate cancer in the UK, with more than 11,000 deaths
However, the current screening test for prostate cancer is so unreliable that applying it to symptomless men across the board would do more harm than good.
The prostate-specific antigen (PSA) blood test is thought to miss around 15 per cent of cancers, while flagging up many which will never pose a risk.
By contrast, the new MRI test, which involves no injection or radiation and does not require a doctor, has been honed to diagnose only cancers which will affect “quantity or quality of life”, according to Professor Mark Emberton, from University College London (UCL), who is co-leading the project.
He believes that around 90 per cent of men who take the test before they reach retirement age can be told with confidence they need never worry about the disease.
“Prostate cancer is pretty slow-growing, so if you’re prostate comes back looking very clean at 55, 60 – I don’t know what age we’ll chose yet – you’re probably very unlikely to get prostate cancer,” he said.
“What’s beautiful about MRI is it overlooks the many, many cancers which don’t need to be diagnosed.
“That’s the revolution.”
Professor Emberton described the test as “pretty close” to perfect, although conceded that policy makers may opt for screening once a decade out of an abundance of caution.
Results of the scans will be classified on a traffic light basis: green indicating all clear, yellow suggesting a need for further tests, and red meaning an urgent referral to a cancer specialist.
Professor Emberton said the scans should cost less than £150 each.
It is intended that, in time, artificial intelligence machines will “learn” to analyse the scans, enabling same-day results for patients.
Survival for men who develop prostate cancer has barely changed in recent decades, although the side-effects of surgery and other treatment, such as impotence and incontinence, are becoming less devastating as techniques improve.
Around 84 per cent of all prostate cancer patients survive for more than 10 years following diagnosis.
The facts | Prostate cancer
- 47,300 UK men were diagnosed with prostate cancer in 2015
- It is the most common cancer among men
- One in eight men will be diagnosed in their lifetime
- That likelihood is doubled for black men, with one in four being affected by the disease
- Men whose fathers or brothers have had prostate cancer are more than twice as likely to develop the disease
- 65–69 is the average age at which men are diagnosed
- 84pc of men survive 10 or more years following a prostate cancer diagnosis
- 11,287 men in the UK died from prostate cancer in 2014 – equivalent to one every hour
- 330,000 men are living with or after the disease in the UK
Karen Stalbow from Prostate Cancer UK said: “This trial could provide an exciting step towards our ambition for a national screening programme that enables men to get the early prostate cancer diagnosis that can save more lives.”
The Institute of Cancer Research (ICR), the UK’s leading research body, said currently it does not support the introduction of universal screening.
However, a spokesman said the ICR may change its position depending on the results of the upcoming trial, which is part of a £6 million REIMAGINE programme funded by the Medical Research Council.
The technical efficacy of the MRI scanning technique has already been “proved” in two previous studies by UCL.
The new trial will seek to establish what proportion of apparently healthy men invited for a scan will take up the opportunity, and the age at which universal screening should be offered.
The National Institute for Health and Care Excellence, which decides what treatments the NHS must offer, has recently approved a more complex, 30-minute MRI scan for patients about to undergo a biopsy for suspected prostate cancer.
A spokesman for NHS England said: ‘NHS England is already rolling out some of the latest developments in MRI scanning for prostate cancer diagnosis and care as part of the NHS Long Term Plan’s ambitions to catch more cancers earlier and save lives.
“This new test is potentially an exciting development that the NHS will look at as more evidence becomes available.