A 10-minute MRI scan could revolutionize prostate cancer screening for men, according to a new study. The scans were found to be far more accurate at diagnosing cancer than traditional blood tests that look for high levels of PSA protein. The MRI scans were able to detect serious cancers that would have been missed by PSA testing alone.
Currently, there is no national screening program for prostate cancer in the UK due to the unreliability of PSA tests. However, men over the age of 50 can request a PSA test. The new study, called the Reimagine study, invited men aged 50 to 75 in London for screening MRI and PSA tests at University College Hospital.
Of the 303 men who participated in the study and had both tests, 48 had a positive MRI indicating cancer. Further tests, including biopsies, confirmed that 25 of these men had significant cancer. Importantly, more than half of the men whose cancer was picked up on MRI had normal PSA test scores below 3ng/ml, indicating that they would have been falsely reassured and unaware of their cancer if they had relied solely on the PSA test.
The study, published in BMJ Oncology, suggests that MRI scans could offer a more reliable method of detecting potentially serious prostate cancers early. Less than 1% of the participants in the study were overdiagnosed with low-risk disease.
One participant, Paul Rothwell, had his prostate cancer diagnosed as a result of the trial. His PSA test was negative, but the MRI revealed the cancer early and allowed for successful treatment. Rothwell expressed gratitude for the MRI, stating that if he had just relied on the blood test, he would have had no idea that there was cancer growing inside him.
PSA tests are considered useful but unreliable indicators of prostate cancer. High PSA levels can also be caused by recent infections or vigorous exercise and sex, leading to overdiagnosis. The study authors recommend further research and a larger study to assess the use of prostate MRI for screening.
The trial also highlighted significant disparities in screening participation among different ethnic groups. Black men were five times less likely to come forward for screening than white men, despite being at higher risk for prostate cancer. It is crucial to develop strategies to reach and encourage more black men to undergo testing.
Prostate cancer survivor Errol McKellar, who runs the Errol McKellar Foundation to raise awareness of prostate cancer, emphasized the importance of addressing mistrust and fear within the African-Caribbean community. He stated that prostate cancer does not discriminate based on race and urged all men to prioritize their health.
Prof Mark Emberton, senior author of the study, expressed confidence that a national screening program could be implemented within the next decade. He stressed that early detection significantly improves the treatability of prostate cancer and can reduce mortality rates in the UK, which are currently twice as high as in countries like the US or Spain.
Prostate Cancer UK and other organizations support the use of MRI scans in diagnosing prostate cancer and are calling for larger, UK-wide studies to determine if MRI-based screening could form the basis of a national program.
In addition to regular screening, it is essential for individuals to be aware of potential symptoms such as increased frequency of urination, difficulty starting urination, weak flow, and blood in urine or semen. It is important to consult a doctor if any changes or symptoms occur, as they can be indicative of prostate cancer or other conditions.