MRI scans could ‘significantly’ reduce prostate cancer deaths

UK

Using MRI scans rather than PSA tests to screen for prostate cancer could “significantly” reduce the number of men dying from the disease, researchers have said.

Prostate cancer is the most common cancer found in men and, at the moment, those aged over 50 can request a protein prostate-specific antigen (PSA) test if they are experiencing symptoms.

But a study of more than 300 men who underwent both methods has found MRIs can detect cancers where PSA tests fail to.

Nearly 50 (16%) of the 303 subjects in the Reimagine study had an MRI scan that indicated the presence of prostate cancer despite an average PSA score.

Of the 48 people researchers identified, 32 had a PSA level below the current screening benchmark of three nanograms per millilitre (ng/ml) and would not have been referred for further investigation.

After NHS assessment, 29 men were diagnosed with cancer that required treatment, 15 of whom had serious cancer and a PSA of less than 3ng/ml.

Three men (1%) were diagnosed with low-risk cancer that did not require treatment.

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The study was led by University College London, University College London Hospitals NHS (UCLH) Foundation Trust and King’s College London and is published in medical journal BMJ Oncology.

The study’s chief investigator, Professor Caroline Moore, a consultant surgeon at UCLH, called the results “sobering” and said they reinforce “the need to consider a new approach to prostate cancer screening”.

“Our results give an early indication that MRI could offer a more reliable method of detecting potentially serious cancers early, with the added benefit that less than 1% of participants were ‘over-diagnosed’ with low-risk disease,” she added.

PSA testing has been linked to over-diagnosis and over-treatment of low-risk cancer.

Professor Mark Emberton, consultant urologist at UCLH, said: “Given how treatable prostate cancer is when caught early, I’m confident that a national screening programme will reduce the UK’s prostate cancer mortality rate significantly.”

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Simon Grieveson, assistant director of research at Prostate Cancer UK, said: “MRI scans have revolutionised the way we diagnose prostate cancer, and it’s great to see research into how we might use these scans even more effectively.”

Another trial, known as Limit, is being conducted with a much larger number of patients, which the research team said is the “next step towards a national prostate screening programme”.

The trial will also attempt to recruit more black men, Mr Grieveson said.