New diagnostic tool ‘could help reduce prostate cancer deaths’

The proposed screening approach could help cut number of false positives detected by current tests.

08 March 2022

A new screening tool for prostate cancer could help reduce the number of deaths from the disease, experts have said.

Researchers have developed a new algorithm estimating a person’s risk of developing prostate cancer based on age and the levels of two prostate cancer markers in the blood.

If the screening method is found to be successful in future studies it is hoped that it could one day be developed into a national screening programme.

There is no single test for prostate cancer but one of the first diagnostic tools used is a blood test that measures the amount of prostate specific antigen (PSA).

A raised PSA result can indicate a problem with a man’s prostate.

But the test isn’t offered to all men as there are both advantages and disadvantages of the test.

It has previously been suggested that screening on PSA levels alone could lead to more men needing a prostate biopsy – where a small sample of cells are collected for further examination – which can have side effects. Others have raised concern about ‘overtreatment’ of a large number of men who have slow growing prostate cancer that would never have affected them during their lifetime.

The new study, published in the Journal of Medical Screening, examined a new algorithm which examines a man’s levels of PSA and hK2 (human kalliknein peptidase) in the blood, as well as taking into account their age.

The paper examined how well the algorithm could predict prostate cancer by comparing blood samples of 571 men who later died after a prostate cancer diagnosis with the blood samples of 2,169 men never who were never diagnosed with the disease.

The authors from UCL, Queen Mary University of London and St George’s University of London, said combining the blood tests with a risk assessment tool could mean that 90% of cancers are detected with 1.2% of cases deemed “false positive”.

This method could help to reduce the number of false positive results by three quarters, the authors added.

Lead author Professor Sir Nicholas Wald, from the UCL Institute of Health Informatics, said: “A key drawback of screening for prostate cancer using a PSA test alone is the higher risk of a false positive, which can lead to an unnecessary, invasive biopsy and the unnecessary treatment of a clinically insignificant cancer that would not have caused harm anyway.

“Our study shows a different screening approach could reduce the number of false positives by three quarters.

“This would make screening for prostate cancer safer and more accurate, reducing overdiagnosis and overtreatment.

“The next step is to test the feasibility of this approach in practice with a pilot project inviting healthy men for screening.

“If the project is successful, we believe this approach ought to be considered as part of a national screening programme for all men.”

Co-author Jonathan Bestwick, from Queen Mary University, added: “The approach is innovative for cancer, as it screens people on the basis of their overall risk rather than the results of a single test.

“This is the same approach used in screening during pregnancy for certain foetal and maternal health conditions.”

Commenting on the study, Professor Roger Kirby, president of the Royal Society of Medicine and vice-president of the charity Prostate Cancer UK, said: “This is a novel approach which utilises the levels of two prostate cancer markers, PSA and hK2 (human kallikrein peptidase) to refine prostate cancer screening.

“The use of PSA alone has significant drawbacks in terms of screening, but the addition of the hK2 marker in this context carries the genuine promise of significantly reducing the death rate from this most common cancer in men.”

Simon Grieveson, head of research at Prostate Cancer UK, added: “Catching prostate cancer early can save lives, but without a screening programme too many men will continue to be diagnosed too late.

“Unfortunately, we currently do not have an accurate enough test to be used for a national screening programme and so it’s great to see promising research like this seeking to create a better test to detect prostate cancer early.

“In the meantime, men can find out more about their risk by using Prostate Cancer UK’s risk checker, and should speak to their GP if they have any concerns.”

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