TRANSFORM trial
The £42 million TRANSFORM trial, the biggest prostate cancer screening trial in 20 years, could save the lives of thousands of men each year.
TRANSFORM update
In May 2024, we launched a £42 million research programme – the TRANSFORM trial – to find the best way to screen men for prostate cancer, so one day all men at risk are invited for regular tests to find aggressive cancers in time for a cure.
It will be the biggest trial in prostate cancer screening for 20 years and has been developed in consultation with, and with the backing of, the NHS, the National Institute for Health and Care Research (NIHR) and the UK Government, who have committed to contribute £16 million. The study is also being supported by our founding partners, donations from philanthropic organisations and other fundraising events.
The TRANSFORM trial, involving hundreds of thousands of men, will compare the most promising tests and provide definitive evidence about the best way to screen for prostate cancer. This is urgently needed. 12,000 men die of prostate cancer each year. It is the most common cancer in the UK without a screening programme, even though it usually has no symptoms until it has spread and become incurable.
With decades of research-funding experience, we’ve brought together the best researchers globally and engaged independent experts to make sure the trial is robust enough and can provide the insight needed to revolutionise prostate cancer diagnosis.
Meet the researchers leading TRANSFORM
The trial’s six lead researchers represent four of the UK’s biggest research centres and are experts in fields such as statistics, imaging and genetics that will be vital to TRANSFORM.
But they won’t work alone. They’ll be supported by a trial management group of researchers and clinicians with skills in areas from behavioural sciences to pathology.
By bringing together a team with this range of skills that cover all aspects of a clinical trial, we can help ensure that TRANSFORM gets the high-quality evidence we need to underpin a national screening programme.
Professor Hashim Ahmed
Professor Hashim Ahmed, Chair of Clinical Urology at Imperial College London, is a researcher and clinician who studies how biopsies, imaging techniques and treatments can be improved for men with prostate cancer.
Professor Rhian Gabe
Professor Rhian Gabe, Professor of Biostatistics and Clinical Trials at Queen Mary University of London, is a statistician with expertise in clinical trials as well as cancer screening, prevention and early detection.
Professor Rosalind Eeles
Professor Rosalind Eeles, Professor of Oncogenetics at The Institute of Cancer Research, London, is a geneticist who has helped find more than 160 genetic differences that contribute to a man’s risk of prostate cancer.
Professor Rakesh Heer
Professor Rakesh Heer, Chair of Urology at Imperial College London, is a surgeon and researcher with a focus on urological cancers and expertise spanning stem cells and basic biology to robotic surgery and clinical trials.
Professor Caroline Moore
Professor Caroline Moore, NIHR Research Professor and Head of Urology at University College London, specialises in using MRI scanning to detect and treat prostate cancer, and personalising men's journeys from screening to treatment.
Professor Mark Emberton
Professor Mark Emberton, Professor of Interventional Oncology at University College London, works to improve diagnosis and treatment for men using new imaging techniques and less-invasive treatments.
Your questions, answered
What's been happening since TRANSFORM was announced?
Since the trial was announced, the researchers leading TRANSFORM have been hard at work turning plans into reality.
They’ve appointed sub-groups to oversee crucial aspects of the trial and produced more than 100 important trial documents – including a detailed protocol, letters, consent forms and easy-read communications.
These documents are now being reviewed by an independent research ethics committee and the NHS, to make sure they’re accurate and the plans are feasible. People affected by prostate cancer have also reviewed letters and consent forms, to check they're written clearly and in a way that will encourage men to take part.
A number of operational plans need to come together for a study of this size, but we are approaching the day when the first men will get a letter from their GP inviting them to take part.
When will the trial start?
We expect that later in 2025, the first men will be invited to take part in the study.
Who will be able to take part in the trial?
The trial is not yet open for recruitment. When it is, men between 50 and 74, or from the age of 45 for Black men, may receive a letter via their GP inviting them to take part in TRANSFORM.
It’s crucial that the study fully reflects the UK population, so invitations to the study will be carefully controlled and it won’t be possible to volunteer. However, if you do receive a letter from your GP about the TRANSFORM study then we strongly encourage you to take part.
Will Black men be recruited to the trial? How will you ensure the trial is diverse?
1 in 4 Black men will develop prostate cancer – double the risk of other men. To make sure the trial provides definitive evidence that will reduce their risk of dying from the disease we have committed to ensuring that at least one in 10 of the men who are invited to participate in the trial are Black men and we’ll be working with the researchers to meet this target.
This is vital as previous trials have not included enough Black men to adequately show the harms and benefits of screening for these men – despite their significantly higher risk.
What exactly will be tested in the trial?
TRANSFORM will compare multiple screening options to each other and the current system, to find the safest, most accurate and most cost-effective way to screen men for prostate cancer.
In stage one, involving around 13,500 men, researchers will compare four potential screening options, including fast MRI scans, genetic testing to identify men at high risk of prostate cancer, and PSA blood testing. A fast MRI is a 12-minute version of the full scan that uses magnetic resonance imaging (MRI) to produce a detailed picture of the prostate.
These approaches will also be compared to a control group, where men will follow the current NHS process – in other words, they won’t be offered a PSA test, but can request one. A control group is vital to prove that any screening programme is more effective than the current process.
In stage two, involving up to 300,000 men, the researchers will test the most promising option, or options, from stage one to see how well this screening method detects cancer as well as any harms it causes – for example, if men are more likely to be treated, and therefore experience side effects, for a cancer that won’t affect them in their lifetimes.
Men will also be followed up for at least a decade after to see how their prostate cancer affects them.
When will we start to see results from TRANSFORM?
There will be multiple points during the trial where new evidence will be generated.
We've worked closely with the UK National Screening Committee (NSC) during the development and assessment of the trial to ensure that the evidence will be complete and robust. The NSC has committed to assessing evidence as it becomes available throughout the trial rather than waiting right until the end for final data to be published.
Separately, the massive scale of the trial will also enable the researchers to collect a bio bank of samples, images and data at a scale never seen before in prostate cancer. This will be available to all kinds of cancer researchers and is predicted to spur a wave of new discoveries and provide proof for the next generation of diagnostics.
How will you fund the trial?
The funding for this £42m programme of research will come from a variety of sources, including government funding, partnerships, and philanthropic donations.
Due to the large commitments from the NIHR and our partners to date, we are confident that we will unlock additional sources of funding required to deliver this ground-breaking trial.
We know that there is always more excellent research in need of funding and will continue our ambitious programme of fundraising to ensure we can fund as much critical research as possible.
I have three sons who will be at higher risk. It would be wonderful to know there was a process to check them regularly.
Thank you for your support
