First men tested in landmark UK prostate cancer screening trial

The first men have been tested as part of a landmark UK trial into the future of prostate cancer screening. The Transform trial, funded by Prostate Cancer UK and the National Institute for Health and Care Research (NIHR), could give results and lead to changes in as little as two years. Experts hope it will inform the future of population-wide prostate cancer screening for men by seeing which tests – such as genetic tests or 10-minute MRI scans – can be combined.

It comes as the UK national screening committee (UKNSC), which advises the Government, publishes its final guidance this week on screening men for prostate cancer.

In a draft recommendation last year, it said no to population-wide screening using the prostate specific antigen (PSA) test, saying it “is likely to cause more harm than good”. The committee put forward only a recommendation to screen men with BRCA1 and BRCA2 genetic mutations – which puts them at far higher risk of prostate cancer – every two years, between the ages of 45 and 61. Health Secretary Wes Streeting said he was surprised by the move but any final decision needs to be “based on science and evidence, not on politics”.

Many experts argue the PSA test is not very reliable because men with a high PSA level may not have cancer and some men with cancer have a normal PSA result. A positive test result may lead to unnecessary treatment for slow-growing or harmless tumours, leaving men at risk of side-effects such as incontinence and erectile dysfunction.

However, others argue current evidence supports wider testing and urged experts to reconsider. The UKNSC has agreed to review any new evidence from the Transform trial. One of the first people tested in the new Transform trial is Jaroslaw Galik, 55, from London.

He and other men attended the InHealth community diagnostic centre in Ealing, west London, for a combination of PSA blood tests, fast MRI scans and/or genetic spit tests to find the safest and most effective way to detect the cancer. Mr Galik said: “I’d heard a bit about prostate cancer over the years and had always thought I should probably speak to my GP, but I never actually got round to doing anything about it.

“There isn’t that routine screening programme, so it just wasn’t something that felt urgent.

“When the letter about Transform came through, I realised this was a straightforward way to check my own risk while also contributing to something bigger.

“If taking part helps move us closer to having a proper screening programme in the future, so men are just invited by their GP like they are for other cancers, that would make such a difference.

“To think that just by taking a couple of tests I could be helping to finally get to screening and save thousands of lives is incredible.” Laura Kerby, chief executive of Prostate Cancer UK, said: “Men across the country are crying out for a screening programme and we’re committed to building a future where every man gets that chance.

“That is why we have driven the development of Transform and funded the £42 million programme, alongside the NIHR.

“We know that a safe and effective mass screening programme could save thousands of men’s lives and it starts with these men walking through the door today and trialling these tests.

“They’re helping to build a future where prostate cancer is found early, consistently and fairly, and where no man’s diagnosis is left to chance.” Mr Streeting said: “Transform is the most ambitious prostate cancer research programme in a generation and I’m proud the Government is backing it.

“The evidence it generates will be crucial in shaping how we screen for this disease for decades to come.” The UKNSC has not recommend specific prostate cancer screening for black men – who are at double the risk of the disease – because of a current lack of data and evidence for this group. The committee also does not recommend targeted screening for men with a family history of the disease, who are also at higher risk of prostate cancer.

With Transform, experts hope to gather more data relating to black men and hope one in 10 men invited to take part will be black. At first, the trial will test new techniques against current NHS methods. The next stage takes the best methods forward to testing in a group of up to 300,000 men.

Professor Lucy Chappell, chief scientific adviser at the Department of Health and chief executive officer of the NIHR, said: “Welcoming the first men to this trial is a huge moment.

“Transform aims to tackle one of the biggest killers as part of the shift from sickness to prevention.

“Importantly, the trial will focus on men at highest risk, particularly black men – a group who face double the risk of developing and dying from prostate cancer.

“The team is working closely with black community leaders and organisations as part of our commitment to ensure meaningful participation in research among everyone in our society.”