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A study published in BMJ Oncology looks at the prevalence of MRI lesions in men responding to a GP-led invitation for a prostate health check.
Prof Sir Mike Richards, Chair of the UK National Screening Committee, said:
“The UK National Screening Committee (UK NSC)1 notes with interest the findings of this study and how it might inform the future research that the authors realise is needed.
“The committee does not currently recommend prostate cancer screening because there is no clear evidence that the benefits outweigh the harms.
“The UK NSC will soon commission a major piece of work to consider 6 prostate cancer screening proposals that were submitted during its annual call for topics2. These include targeted and risk-stratified screening proposals for screening groups of men at higher risk due to factors such as ethnicity and family history.
“In order to make any positive recommendation, the UK NSC would need to see high quality peer-reviewed research that demonstrates that a screening strategy would improve prostate cancer outcomes while minimising serious harms such as overdiagnosis, associated overtreatment and side effects.”
1 https://www.gov.uk/government/organisations/uk-national-screening-committee/about/recruitment
Prof Nick James, Professor of Prostate and Bladder Cancer Research at The Institute of Cancer Research, London, and Consultant Clinical Oncologist at The Royal Marsden NHS Foundation Trust, said:
“This study, where MRI used as an initial screening test, 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 over diagnosis and linked over treatment are increasingly mitigated by the use of MRI. Similarly, MRI can also spot cases of prostate cancer in patients with normal PSA levels, who would have been missed using PSA only screening programmes.
“This study adds further important data on the potential use of MRI as an upfront test independent of PSA and will allow planning of further studies aimed at optimising screening strategies.
“One point of concern in this study are the demographics of the participants. The authors acknowledge that older white men, arguably with lower benefit from screening, were over-represented whereas black men, who have much higher risks of both prostate cancer diagnosis and death, and hence more to potentially gain, were under-represented. Targeting these inequalities must be an important aspect of future studies in this area.”
Prof Ros Eeles, Professor of Oncogenetics at The Institute of Cancer Research, London and Consultant in Clinical Oncology and Oncogenetics at The Royal Marsden NHS Foundation Trust, said:
“This study reports the use of MRI of the prostate to reduce the overdiagnosis of prostate cancer that can arise from using PSA blood screening alone.
“At The Institute of Cancer Research we are investigating whether the use of genetic information can help to identify men at higher risk of prostate cancer in whom targeting prostate cancer screening using imaging methods, such as MRI, would identify more prostate cancers of the type which do need treatment.”
‘Prevalence of MRI lesions in men responding to a GP-led invitation for a prostate health check: a prospective cohort study’ by Caroline M Moore et al. was published in BMJ Oncology at 00:05 UK time on Tuesday 22 August.
DOI: 10.1136/bmjonc-2023-000057
Declared interests
Prof Ros Eeles: “No declarations of interest.”
Prof Nick James: “No declarations of interest.”
For all other experts, no reply to our request for DOIs was received.