‘Game-changing’ new trial of prostate cancer test rolled out on NHS to catch disease early
A NEW prostate cancer trial is being rolled out on the NHS, aiming to find the best screening techniques to catch the deadly disease early.
Eligible men in the UK are being asked to enrol in the major trial – the biggest in decades – with the first invitation letters being sent out by GPs.
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The trial will evaluate the accuracy and safety of multiple tools for spotting prostate cancer, including PSA tests and MRIsCredit: Getty
Health Secretary Wes Streeting hailed the £42 million project, dubbed Transform, as a “game-changer”.
Meanwhile, experts hope it could help save thousands of lives.
Professor Hashim Ahmed, chief investigator of the trial, described it as the “the biggest and most ambitious trial I’ve ever been part of”.
“The start of recruitment today marks a pivotal step towards getting the results men urgently need to make prostate cancer diagnosis safe and more effective, so that we can unlock the potential of prostate cancer screening in the UK,” he said.
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The study will compare various screening methods to current NHS diagnostic processes – which can include blood tests and biopsies.
Some 16,000 men will be recruited for the first stages of the trial, which will assess prostate-specific antigen (PSA) blood tests, genetic testing and a faster version of the MRI scan – known as a prostagram – against current NHS diagnostic methods, to see which performs best.
The trial will also look at spit tests, which extract DNA from saliva, to see if they’re more accurate than PSA readings, according to the BBC.
Patients aged between 50 and 74 – or between 45 and 74 for some groups – will be invited directly by their GP.
Men can’t volunteer for the trial, but Prostate Cancer UK is urging anyone who receives a letter to take part.
The first testing will be at the InHealth community diagnostic centre in Ealing, with more set to open across the UK.
The trial’s second stage, involving up to 300,000 men, will test the most promising options from stage one of the trial.
Prof Ahmed, chairman of urology at Imperial College Healthcare NHS Trust and Professor of Urology at Imperial College London, said: “Combining our world-class team of UK researchers, the latest screening techniques like fast MRI scans, PSA blood tests and genetic tests, we can find the best way to screen men for prostate cancer – minimising late diagnosis, saving more lives and doing so with fewer harms.
“Importantly, we’ve designed the study so that we can evaluate promising new tests as soon as they’re developed.”
Laura Kerby, chief executive of Prostate Cancer UK, said: “The future of prostate cancer screening starts today.
“It’s incredible to see the launch of this once-in-a-generation trial that so many people have worked to make possible, from our scientists to our amazing supporters raising funds.”
There is currently no screening programme for prostate cancer in the UK. One of the reasons is concerns about the accuracy of PSA tests.
However, the launch of Transform comes as the UK National Screening Committee (NSC) prepares to announce its decision on whether current evidence supports the introduction of screening for the disease.
The trial will test new ways to diagnose the disease that could spot cancers that today’s methods miss.
One in eight men will get prostate cancer
The risk of developing prostate cancer depends on many factors, here are some of the facts about the disease and how many men it affects.
- One in eight men will get prostate cancer in their lifetime
- It is the fourth most common cancer worldwide, and the most common in men
- There are 63,000 new cases every year in the UK, and 1.5million globally
- Around 12,000 people lose their lives to prostate cancer annually in the UK and almost 400,000 around the world
- Prostate cancer accounts for 28 per cent of all new cancer cases in men in the UK, and 14 per cent of all new cancer cases in men and women combined
- Prostate cancer survival has tripled in the last 50 years in the UK
- More than three-quarters (78 per cent) of patients survive for 10 or more years
- About 510,000 men are living with and after prostate cancer in the UK
- It is most common in men aged 75 to 79
- Since the early 1990s, cases have increased by 53 per cent in the UK
- Mortality rates are up 16 per cent since the early 1970s in the UK
- Incidence rates are projected to rise by 15 per cent in the UK between 2023 to 2025 and 2038 to 2040
- Mortality rates are expected to fall five per cent in the UK over the same years
BRCA genes and risk of prostate cancer
BRCA1 and BRCA2 are two genes that everyone has. They keep healthy cells growing normally and prevent the growth of cancer cells.
In a small number of people, these genes change and don’t work properly – this is called a gene variant. Your body can create these gene variants over time, or they can be inherited.
Men with a BRCA2 gene variant have a higher risk of developing prostate cancer during their lifetime.
If you have a BRCA1 variant, your lifetime risk of developing prostate cancer may only increase slightly.
Some research suggests that having a BRCA1 or BRCA2 gene variant may also increase your risk of being diagnosed with prostate cancer at a younger age or having aggressive prostate cancer.
In the general population, around 1 in 300 to 400 people have a BRCA gene variant.
But people from an Ashkenazi Jewish background have a higher risk – around 1 in 40 people may carry a BRCA gene variant.
NHS England is offering free BRCA gene testing for anyone living in England who is aged 18 or over and has one or more Jewish grandparent. For more info, visit jewishbrca.org or nhsjewishbrcaprogramme.org.uk.
Source: Prostate Cancer UK, World Cancer Research Fund International and Cancer Research UK
But the trial will also quickly produce robust new information about the tests currently used, Prostate Cancer UK says.
If the NSC decides there’s not enough evidence to recommend screening now, the charity claimed early results from the trial could help shift the evidence in favour of screening in as little as two years.
Currently, the onus lies on men to request a PSA test from their GP. They can do so from the age of 50.
The test looks for abnormally high levels of protein in the blood, but it’s considered unreliable as its levels can be elevated by conditions other than cancer, such as an enlarged prostate or an infection.
It may also pick up low-risk prostate cancers that would never need treatment, or miss others that do.
Transform will be delivered in partnership with the NHS through the National Institute for Health and Care Research (NIHR), which has committed £16 million in funding.
The remainder is coming from Prostate Cancer UK.
Ms Kerby said: “The men signing up for the study, and the people who donate to keep it running, will have the power to help save thousands of lives each year in the UK and even hundreds of thousands globally.”
Prostate cancer is the most common cancer in males in the UK, with around 55,000 new cases every year.
Transform will also aim to tackle inequalities when it comes to prostate cancer diagnosis and care.
It’s still a good idea to get it checked out if you have any of these symptoms – but not everyone will get symptoms from prostate cancer
Black men are twice as likely to get the disease and twice as likely to die from it.
At least one in 10 men invited to join the Transform trial will be black, Prostate Cancer UK said.
Mr Streeting said: “Prostate cancer is one of the biggest killers of men in the UK.
“Devastatingly, around one in eight will get it and that risk is doubled in black men.
“But today marks a turning point for prostate cancer care in this country as the first men are invited to take part in this game-changing trial funded by the Government and Prostate Cancer UK.”
Mr Streeting vowed to “look carefully” at the recommendations from the NSC and said he is “determined to bring about genuine change”.
It comes as the Government launched its first men’s health strategy earlier this week.
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It recommended some patients be given at-home PSA tests to monitor prostate cancer more easily.
They could be introduced from 2027 following clinical validation, although Prostate Cancer UK called for more details and warned that more work was needed before PSA tests can be recommended for home use.
