MRI Scans Show Promise in Prostate Cancer Detection, Study Suggests
Recent research conducted by oncologists from University College London has revealed that MRI scans could revolutionize the detection of prostate cancer, potentially leading to a reduction in both the death rate from the disease and unnecessary treatment. The findings recommend the routine use of MRI as a primary screening tool for prostate cancer, without requiring men to make a specific request for the scan.
Traditionally, men showing symptoms of prostate cancer would need to have a prostate-specific antigen (PSA) score exceeding 3ng/ml in order to be considered for further tests, such as a biopsy. Elevated levels of PSA, a protein found in the blood, may indicate the presence of cancer. However, MRI scans have demonstrated that 50 percent of men with severe prostate cancer had PSA levels below the threshold, suggesting that these individuals would not have been eligible for additional testing under the existing system.
The study involved 303 men aged between 50 and 75 who were assessed by the United Kingdom’s National Health Service. Of these participants, 48 were diagnosed with prostate cancer. Surprisingly, 16 percent of the men had undiagnosed prostate cancer with an average PSA density of just 1.2ng/ml. Approximately two-thirds of these individuals would not have met the referral threshold of 3ng/ml according to current guidelines.
Professor Caroline Moore, the chief investigator of the study, highlighted the potential benefits of using MRI as a more reliable method for detecting potentially serious cancers early. She noted that the fact over half of the men with clinically significant cancer had PSA levels below the threshold is a concerning implication of the current approach to prostate cancer screening.
The standard protocol for prostate cancer screening typically involves a PSA blood test followed by a digital rectal exam, with a biopsy performed if cancer is suspected. Although this method has reduced prostate cancer mortality by 20 percent over 16 years, it has also been associated with over-diagnosis, excessive treatment for less aggressive cancers, and potentially unnecessary and invasive biopsies.
In contrast, MRI scans have already shown their ability to prevent unnecessary biopsies in one in four high-risk men. However, the study’s recruitment data indicated a significant disparity, with Black men participating at just one-fifth the rate of White men. This highlights the importance of targeted initiatives to ensure inclusiveness and reach all communities.
The study forms part of the REIMAGINE consortium, which aims to transform the diagnosis of prostate cancer. The researchers intend to expand their study and are particularly focused on recruiting more Black participants due to their higher risk of developing the disease. Initiatives such as mobile scan in a van projects have been proposed to reach communities that may be less inclined to respond to traditional invitations from doctors.
Professor Mark Emberton, a consultant urologist at UCLH and a member of the research team, expressed confidence that a national screening program using MRI scans could significantly reduce the prostate cancer mortality rate in the UK. He recognizes the need for further work to achieve this goal, but believes it is possible within the next five to ten years.
In conclusion, the recent study highlights the potential of MRI scans in revolutionizing prostate cancer detection. By adopting MRI as a routine screening tool, more cancers could be detected early, reducing both the death rate and the burden of unnecessary treatment. The need for further studies, particularly with more diverse populations, is crucial to evaluate and validate this approach. The research also underscores the importance of inclusivity and targeted strategies to ensure that all men, regardless of ethnicity, have equal access to prostate cancer screening and early detection.
