Behind the headlines: ‘game-changing’ new scan could pave the way to screening

New study shows ‘fast MRI’ scanning technique could pick up more prostate cancers that need treatment than the current PSA test alone, potentially providing a crucial piece of the puzzle towards a screening programme.

The earlier prostate cancer is caught, the more likely it is to be cured. A screening programme would help catch more men’s cancer at this early stage, potentially saving thousands of lives.

But current ways to diagnose the disease, such as the PSA test, aren't accurate enough to be used alone in a screening programme. The PSA test can over-diagnose prostate cancer (deeming it to be more harmful or life-threatening than it actually is) when it doesn’t require treatment, causing men unnecessary harm through over-treatment; and the test can also miss some cancers that do need treatment.  

Thanks to research and campaigning work that you supported, we've increased the availability of mpMRI before biopsy to improve the accuracy of diagnosis, sparing some men the need for a biopsy. But we still don’t have the full picture we need to make an accurate screening programme a reality for men. This research from Imperial College London could help bring us another step closer to our goal.

Potential to catch more harmful cancers without risk of overtreatment

The researchers in the PROSTAGRAM trial screened 400 men aged 50-69 for prostate cancer using either the PSA test, or a 15-minute bi-parametric (bp) MRI scan. The team found that bpMRI scans detected more prostate cancers that required treating than the PSA test, while crucially not increasing the number of cancers that were over-diagnosed.

This is evidence that scanning-based screening could help tip the balance towards a programme which catches more prostate cancers at the early stages without risking harming men through over-treatment.

Dr Matthew Hobbs, our Associate Director of Research Impact, said: “We desperately need an effective screening programme for prostate cancer to help us stop so many men dying from this disease. This exciting trial shows for the first time that a screening programme which is based on MRI scans rather than blood tests might one day provide the answer we’re looking for.”

More research needed before men see a screening programme

Dr Hobbs continued, “It gives us another piece in this complicated but crucial jigsaw, but what we need now is a large trial that extends this approach to more men.”

These results are an important ‘proof of principle’ for using bpMRI as part of a prostate cancer screening programme, but more research will be needed to test this technique in more men, over a longer period of time, to confirm that men would see a long-term benefit from any potential screening programme using bpMRI.

It would also be important to assess the time and costs associated with the scans before a bpMRI-based screening programme could be rolled out. Ideally, future clinical trials will compare bpMRI with other promising techniques to see which test, or combination of tests, would make the most effective screening programme."

Dr Hobbs explained, “The best tests will need to provide early and accurate diagnosis of significant cancers before they spread outside the prostate, without over-diagnosing men with low-risk cancers, who could safely avoid invasive tests and treatments.”

“Prostate Cancer UK is committed to finding a suitable screening programme for men. We’re already working with the University of Sheffield and the National Screening Committee to work out exactly what research is needed to make that a reality as soon as possible.”

Medical research has come to a standstill under lockdown. But prostate cancer doesn’t stop, so we don't either. To stop men's lives from being limited by prostate cancer we urgently need the funds to make sure the life-saving progress we’ve made is not lost.

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