International experts back new form of prostate cancer screening,
Experts are urging officials to rethink their decision on prostate cancer screening after a breakthrough MRI approach was shown to slash the need for invasive biopsies by half – while speeding up diagnoses.
It comes just days after government advisors rejected calls for a nationwide prostate cancer screening programme – a move critics warned could condemn thousands of men to an avoidable death.
Now campaigners say the decision should be revisited in light of new evidence.
‘This paper adds to a growing international consensus around the use of faster, simpler MRI scans that could make prostate cancer screening more practical and affordable,’ David James, a spokesperson from Prostate Cancer Research, said.
‘The Committee has said its prostate cancer model is a living model, and we believe this important new evidence should now be considered as part of that ongoing process.
‘Screening policy must continue to evolve alongside innovation and the evidence base.
‘We urge the Committee to revisit how MRI is represented within their model to ensure it reflects expert consensus on faster, simpler MRI scans for screening populations.’
World-leading experts behind the new recommendations say MRI testing could transform the diagnostic pathway, offering a safer, more accurate alternative to traditional testing.
Last week the The UK National Screening Committee rejected calls for a nation-wide prostate cancer screening programme
Under the proposed approach, men would be offered an MRI after receiving a positive PSA test, before any biopsy is considered – a step experts say would allow doctors to act on lower PSA levels and detect cancers earlier.
‘We recommend that screening MRI should be used following a PSA test,’ the experts behind the Prostate Imaging for Screening Magnetic Resonance Imaging (PRISM) recommendations said.
Rather than screening all men once they reach a certain age, the panel recommended a more personalised approach, based on risk.
Men at low-risk of the disease would be offered an MRI every four to five years, while those at higher risk – such as black men and those with a genetic predisposition – should be screened more frequently.
Biopsies, which can be painful and lead to sexual problems, should only be carried out if MRI scans – read by highly trained doctors – flag clearly suspicious results.
The panel said this stricter, more personalised approach could slash biopsies in half, while detecting roughly the same amount of cancers.
Data suggests this could nearly double the accuracy of positive tests, significantly slashing rates of overdiagnosis.
Led by urology specialist Nikhil Mayor from Imperial College London, the experts reviewed six studies including more than 1,900 participants.
Of these, 1,426 underwent upfront MRI screening.
Based on the study results, experts agreed that screening should commence at age 50 for the general population, with black men invited from 45 onwards.
They also agrees that MRI should not be offered to those with a life expectancy of less than 10 years, reflecting the natural history of prostate cancer management.
The decision to biopsy should not be based solely on the interpretation of an MRI screening by an artificial intelligence model, the experts added.
They concluded that incorporating MRI into screening programmes has the potential to fundamentally reshape prostate cancer screening by reducing unnecessary procedures while maintaining if not improving detection of clinically significant disease.
The Daily Mail has long led campaigns to improve the diagnosis and treatment of prostate cancer in a bid to end the needless deaths.
Experts have long suggested the implementation of MRI could free up appointments for prostate cancer treatment each year, helping drive down waiting lists while reducing the need for invasive procedures.
Prostate cancer is the most common cancer in men, affecting one in eight, with around 63,000 new cases and 12,000 deaths in the UK every year – but unlike breast, bowel and lung cancer, there is currently no national screening programme.
The UK National Screening Committee rejected calls last week, concluding that only men aged 45 to 61 who have particular gene mutations combined with a family history of breast, ovarian, pancreatic, or prostate cancer should qualify.
It means as few as 3,000 men will be invited for screening, which will involve taking a blood test every two years to check for a marker of potential prostate cancer known as PSA.
A spokesperson from the Department of Health and Social Care said: ‘The UK NSC us led by science, and the committee continues to review evidence that might change screening recommendations when it becomes available.
‘This government is providing funding to the £42 million TRANSFORM trial, which has the potential to revolutionise prostate cancer screening by helping us better understand diagnostic pathways, including the use of MRI.’
