Using MRI scans to screen men for prostate cancer could reduce deaths from the disease significantly, researchers have suggested.
Scientists said current tests, which detect the level of the protein prostate-specific antigen (PSA) in the blood, have been linked to overdiagnosis and overtreatment of low-risk cancer.
Prostate cancer is the most common cancer found in men and, at the moment, those aged over 50 can request a PSA test if they are experiencing symptoms. The Reimagine study invited 303 men aged between 50 and 75 to have a screening MRI and a PSA test.
Prof Caroline Moore, consultant surgeon at University College London hospital (UCLH) in London and chief investigator of the study, said the research is sobering and “reiterates the need to consider a new approach to prostate cancer screening”.
Of the participants, 48 (16%) had an MRI that indicated the presence of prostate cancer despite having a median PSA density. From that group, 32 had lower PSA levels than the current screening benchmark of 3ng/ml, meaning they 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.
The study was led by University College London, with University College London Hospitals NHS foundation trust and King’s College London, and is published in the medical journal BMJ Oncology.
Moore added: “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 ‘overdiagnosed’ with low-risk disease.”
Prof Mark Emberton, consultant urologist at UCLH, said: “The UK prostate cancer mortality rate is twice as high as in countries like the US or Spain because our levels of testing are much lower than other countries.
“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. There is a lot of work to be done to get us to that point, but I believe this will be possible within the next five to 10 years.”
Nick James, a professor of prostate and bladder cancer research at the Institute of Cancer Research in London, said the study “further reinforces the value of MRI in the diagnostic pathway for prostate cancer”.
“The well-known limitations of the old PSA-based screening studies of overdiagnosis and linked overtreatment are increasingly mitigated by the use of MRI,” he added.
Simon Grieveson, assistant director of research at Prostate Cancer UK, said: “MRI scans have revolutionised the way we diagnose prostate cancer.
“These results are extremely exciting, and we now want to see much larger, UK-wide studies to understand if using MRI as the first step in getting tested could form the basis of a national screening programme.”
