New prostate cancer scanner to replace invasive exam

A patient undergoing an MRI. Prostagram uses an MRI and is based on the detection of breast cancer. Photograph: Juice Images / Alamy / Alamy

Scientists say they have developed a prostate cancer scanner accurate enough to potentially replace current invasive screening techniques and save thousands of lives each year.

Prostagram, developed by experts at Imperial College London, employs MRI and is based on breast cancer screening, where women are routinely offered a mammogram every three years as part of a national program.

A trial of 408 men, the results of which were published in Jama Oncology on Thursday, found that Prostagram detected about twice as many clinically significant cancers as the standard PSA (prostate-specific antigen) blood test.

Previous MRIs have had reliability issues, but the Prostagram, which has identified around 75% of aggressive prostate cancers in volunteers, is the first that is accurate enough to be considered for screening. The researchers say that the trial results suggest that the 15-minute scan could find an additional 40.000 cases of prostate cancer a year in the UK alone.

Professor Hashim Ahmed, lead author and chair of urology at Imperial College London, said: “Prostagram has the potential to form the basis of a national rapid and mobile screening program for prostate cancer and could be a game changer. Prostagram also has the potential to detect more aggressive cancers earlier and miss the many cancers that don't need to be diagnosed. By finding these aggressive cancers as early as possible, men have the opportunity to be offered less invasive treatments with fewer side effects. "

The number of deaths from prostate cancer in the UK has exceeded the number of deaths from breast cancer (approximately 12.000 compared to 11.000), and the national breast screening program has saved approximately 1.300 lives per year.

Last year, prostate cancer published research showing it to be the most commonly diagnosed cancer in the UK, with 57.192 new cases in 2018.

PSA tests are not recommended for screening because they are unreliable and can produce false positive results, while digital rectal exams (DREs) are invasive, which can discourage men from getting tested and also have reliability issues .

A third of the men in the Prostagram trial were black, which is significant given their increased risk of prostate cancer. One in four black men in the UK will be diagnosed with prostate cancer in his lifetime compared to one in eight in the general UK population.

Dr. David Eldred-Evans, another researcher and developer of the Prostagram, said: “Plans for a larger trial covering 20.000 men are well advanced and will be carried out in the next few months subject to funding. If the results of this study are similar to or better than those revealed today, then there is a clear path towards the widespread implementation of Prostagram in the general population. "

Sponsors of the research, which has been supported by Stephen Fry, include the Urology Foundation, the Wellcome Trust, the BMA Foundation for Medical Research, and the National Institute for Health Research Imperial Biomedical Research Center. / Source: theguardian.com

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