Prostate cancer remains the most common cancer in men in the UK, affecting one in eight during their lifetime. More than 40,000 new cases are diagnosed each year with an estimated 10,000 deaths annually.
Treatment options depend on how early the disease is diagnosed and how far it may have spread. Diagnosis depends on investigations and can be difficult, particularly in the early stages. At the moment, prostate cancer is not subject to any national screening programme.
Although there is a prostate specific antigen (PSA) test, it is a rather crude and inconclusive means of investigation. The test is not regarded as sufficiently accurate for a national screening process. If the PSA result is raised, however, it increases the suspicion of prostate cancer and further, often invasive, investigations or treatment will follow.
A screening programme that can better diagnose the presence or otherwise of prostate cancer is therefore a key priority in cancer research.
In the journal Nature Genetics, a new study has been published on a DNA test created at the Institute of Cancer Research in London. Scientists studied data of over 140,000 men to identify new genetic combinations that increase the risk of prostate cancer. By joining these with previously identified combinations, they have developed a saliva test for prostate cancer risk. This works on determining a patient’s DNA code to identify the genetic risk of developing prostate cancer.
Scanning and biopsies can then be limited to only those men who fall within the higher risk categories. This should also increase awareness of the warning signs and symptoms in those at greatest risk, as well as avoiding the distress to patients and the cost to the NHS of unnecessary scans and biopsies in those who are unlikely to have the disease.
The test is currently under trial at three GP practices in London and is expected to be rolled out more widely next year.
Welcoming the news, Andrew Clayton of Penningtons Manches' clinical negligence team comments: "There are huge benefits of a national screening programme for prostate cancer. We know from our clients that the uncertainty inherent in PSA testing can be distressing and that delays in diagnosis and treatment have a profound impact on the spread of the disease and patients’ prognosis. Definitive investigations to diagnose the disease are common and obviously provide reassurance in many cases, but the distress and cost could be reduced with more effective screening and diagnosis.
“Early diagnosis offers the least invasive treatment options and generally the best outcome. Further tests to distinguish those at risk of the most aggressive forms of the disease would have enormous potential. Any breakthroughs in improving the diagnosis of prostate cancer would have profound benefits both for patients and the NHS.”