‘A pivotal moment’: why our TRANSFORM trial is the key to prostate cancer screening for all men

In the last few days, hundreds of men have received a very important letter in the post. One that marks a pivotal moment for prostate cancer research and brings hope of a better future for men.  

These men are the first who’ll be invited to take part in our landmark screening trial, TRANSFORM. It’s a major milestone in this once-in-a-generation research project, as we begin gathering the critical evidence that will lead us to a nationwide screening programme for all men. 

Last week the UK National Screening Committee said we don’t have the evidence we need for a mass screening programme today. But TRANSFORM is our best chance of changing this. And as this groundbreaking trial gets under way, we’re moving ever closer to routine screening for every man at risk of the disease.  

So here are three important reasons why TRANSFORM gives us real hope of achieving a better future for men – and a world where early diagnosis is no longer left to chance. 

Following its review of the latest evidence, the National Screening Committee has said “no” to a mass screening programme inviting all men for regular tests. Instead, it’s recommended routine screening for men who have a higher risk of prostate cancer due to variations in their BRCA genes. 

The decision means that tens of thousands of men who have these genetic variations could soon be invited for screening, giving them the best chance of finding prostate cancer early – when it’s easier to treat. 

But for the millions of others – including hundreds of thousands more men who are at high risk of the disease – the committee says we need more evidence, to show that the benefits of early diagnosis will outweigh the possible harms of unnecessary biopsies and treatments. 

This is where TRANSFORM could make all the difference. The trial will produce new information about the tests we currently use to diagnose prostate cancer. And in as little as two years, these early results could be enough to make screening a reality for many more men. 

The National Screening Committee has agreed to review this potentially critical new evidence as soon as it’s available. 

In the past, methods for diagnosing prostate cancer were unreliable and often led to men having unnecessary biopsies and treatments that could cause harmful side effects. That’s why there’s never been a screening programme in the UK before. 

But in recent years, research that we’ve funded has driven major improvements in testing – finding safer and more accurate ways to diagnose the disease. 

As the biggest and most ambitious trial of its kind for more than 20 years, TRANSFORM is the final piece in this puzzle. It will provide definitive answers to the remaining questions, showing us the best way to test men for prostate cancer at a large scale.  

Researchers will analyse the most promising screening techniques – including PSA blood tests, genetic spit tests and fast MRI scans – and compare them with the way the NS currently diagnoses prostate cancer. And by testing the most effective approaches in a large group of up to 300,000 men, they’ll unlock the definitive evidence for the best way to screen men for the disease.

In the process, they’ll also build the biggest ever bank of prostate cancer samples, images and data, which will enable future researchers to test new treatments and diagnostic methods faster than ever before. 

“Right now, too many men are diagnosed with prostate cancer by chance, with many finding out when it’s already too late for a cure,” says our Director of Research, Dr Matthew Hobbs.  

“We know early diagnosis would save thousands of these men’s lives every year. TRANSFORM is the research that will get us there, and we’re proud to be leading the way. It’s a pivotal moment for prostate cancer research.” 

Without a mass screening programme, early diagnosis will be left to chance for the vast majority of men – including hundreds of thousands who are at high risk of prostate cancer. 

For Black men, the inequalities are particularly stark. Not only do Black men face double the risk of getting prostate cancer, they’re also more likely to be diagnosed at a later stage – and at the same time less likely to get the best treatments on the NHS. The combined impact of these shocking inequalities means Black men are dying disproportionately from a curable disease. 

TRANSFORM will help to change this. In the past, too few Black men have been invited to take part in prostate cancer research – and this means we don’t have as much reliable evidence to show how effective screening would be for them.  

But our trial will be different, ensuring at least one in 10 men who are invited by their GP to take part are Black – and making sure the results are reliable for men who face the greatest risk. 

While we drive forward the vital research that will help us extend screening to even more men, the Government can’t stand still and wait. Ministers must act now on early detection – to start saving men’s lives today.  

Without routine screening, it’s important that every man knows his risk right now – so he can make an informed choice about having a PSA blood test to check for early signs of prostate cancer.  

But today, outdated NHS guidelines prevent GPs from discussing prostate cancer testing with men unless they already have symptoms.  

So we’re calling on ministers to change NHS guidelines immediately, to give GPs the power to have potentially lifesaving conversations with men at highest risk. We’re also urging them to fund public awareness campaigns that would help millions more men find out if they’re at risk and what to do next, while replacing confusing clinical guidance with our quick and easy online Risk Checker.