After today's confirmation that mpMRI scans before a biopsy can radically improve the accuracy of prostate cancer diagnosis, figures reveal that just 32% of eligible men currently have access to the procedure because of a shortage of scanners and qualified staff to use them in the NHS.
The results of a ground-breaking research trial, called PROMIS, have finally been made official and show that giving a man a multi-parametric MRI (mpMRI) scan before a biopsy radically improves the accuracy of detecting harmful prostate cancer, while also reducing the number of unnecessary biopsies by a quarter.
But freedom of information requests made by Prostate Cancer UK reveal that without urgent action, just a third of eligible men with suspected prostate cancer have access to mpMRI scans in the UK because of a lack of equipment and qualified staff to do them.
Combining up to four different types of image, mpMRI creates a more detailed picture of your prostate than a standard MRI scan, and can help guide the needles of a TRUS biopsy to more accurately target any cancer found. In the PROMIS trial, only 11% of harmful prostate cancers were missed using mpMRI, whereas 26% were missed using a TRUS biopsy alone.
Responding to the findings, Prostate Cancer UK's chief executive, Angela Culhane, said:
This is the biggest leap forward in prostate cancer diagnosis in decades with the potential to save many lives, so it’s critical that urgent action is taken to make it available to men
"However, this complex technique can only become a routine part of the diagnostic pathway once it can be guaranteed it can be rolled out safely and in a way that produces the best outcomes for men. We are committed to doing everything we can to make this happen."
Since PROMIS's preliminary findings were published last June, we've been working with a range of clinical experts and professional bodies to pin-point potential barriers to rolling out routine mpMRI scans before biopsy on the NHS – from having enough working scanners to training clinicians to use them and interpret the results – and started addressing them ahead of time.
We’re already developing a bespoke training programme for radiologists with the Royal College of Radiologists, and are working on a checklist for those who commission and fund cancer services. We’re also collaborating with University College London Hospital (which ran the PROMIS trial) to develop a clinical consensus, setting standards and guidelines to ensure all men receive the same quality of mpMRI scan wherever they are.
Following our freedom of information requests, we'll be speaking to national health bodies to establish where resources can best be targeted to increase the numbers of men accessing this new technique. That way we can make the most of already-stretched NHS funding to ensure as many men as possible benefit from mpMRI before a biopsy.
It was thanks to our funding of a pilot study into mpMRI by Hash Ahmed and Mark Emberton at University College London Hospital in 2010, that the research team went on to secure £2 million of Government funding to carry out the PROMIS trial. But mpMRI is just one of the ways we’re working to improve diagnosis of prostate cancer.
We also funded the PROMIS trial's researchers to collect and store blood and urine samples from the men taking part, to see if tests using biomarkers can be developed to improve diagnostic accuracy even further. And we’ve just launched our Stronger Knowing More campaign to raise awareness among black men of their great risk of prostate cancer.
It's all part of our ongoing strategy to tame the most common cancer in men within ten years.