{"id":27560,"date":"2021-10-20T12:40:57","date_gmt":"2021-10-20T12:40:57","guid":{"rendered":"https:\/\/news.cancerresearchuk.org\/?p=23683"},"modified":"2024-11-03T15:14:11","modified_gmt":"2024-11-03T15:14:11","slug":"targeted-prostate-cancer-screening-are-we-there-yet","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/targeted-prostate-cancer-screening-are-we-there-yet\/","title":{"rendered":"Targeted prostate cancer screening: Are we there yet?"},"content":{"rendered":"
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1 in 2 of us will get cancer in our lifetime. All of us can support the research that will beat it.<\/p>\n

Donate<\/a><\/div>\n<\/div>\n<\/div>\n

\"prostate<\/p>\n

Prostate cancer biopsy histopathology.<\/p>\n<\/div>\n

Prostate cancer screening is back in the news<\/a>, as headlines suggest that year prostate checks could benefit some men at higher risk of cancer.<\/p>\n

It\u2019s a hotly debated topic. Many studies have investigated the benefits of a blood test \u2013 called the PSA (or prostate specific antigen) test<\/a> in picking up prostate cancer in men without symptoms, but overall they point to the test not being reliable enough to save lives in the general population.<\/p>\n

But what about a more targeted approach, where screening is offered to people on the basis of things other than their age and sex?<\/p>\n

Here\u2019s a rundown of the latest study, what it means and what we still need to know.<\/p>\n

Why targeted screening?<\/h2>\n

The latest study, which we part funded, isn\u2019t the first to investigate whether the PSA test can be used to screen for prostate cancer<\/a>.<\/p>\n

In 2018, our researchers reported<\/a> that offering a one-off PSA test to men without symptoms didn\u2019t save lives and could do more harm than good.<\/p>\n

Now, researchers are exploring whether a more targeted approach may be more successful. This would involve identifying people at a higher risk of prostate cancer and offering them screening.<\/p>\n

\u201cPicking up cancers early, when they are more much likely to be curable, is a vital part of the mix as we try to improve the lives of cancer patients,\u201d says Professor Kristian Helin, chief executive of The Institute of Cancer Research, London<\/p>\n

\u201cMass screening isn\u2019t a good option in prostate cancer because of the risk of overdiagnosis<\/a>, but in men who have a high inherited risk of aggressive disease it makes much more sense.\u201d<\/p>\n

Which brings us to the IMPACT trial.<\/p>\n

Who was screened?<\/h2>\n

The IMPACT trial looked at whether targeted screening could benefit people with an inherited condition called Lynch syndrome.<\/p>\n

Lynch syndrome affects 1 in 279 people<\/a>. People with this particular condition \u2013 caused by faults in a number of genes (MLH1<\/em>, MSH2<\/em>, MSH6<\/em> and PMS2<\/em>) \u2013 are at an increased risk of bowel cancer, with around 7 in 10 people developing the disease.<\/p>\n

There\u2019s also some evidence that Lynch syndrome can also increase someone\u2019s risk of developing other cancers, including prostate cancer.<\/p>\n

And it\u2019s this group the IMPACT team were interested in for this study. Led by scientists at The Institute of Cancer Research, the IMPACT study involved 828 men aged 40 to 69 from families with suspected genetic increased risk of prostate cancer.<\/p>\n

The team wanted to know if regular PSA testing could pick up prostate cancer in these men. Men with faults in these particular genes (carriers) were matched with a control group that didn\u2019t carry the same genetic faults (non-carriers).<\/p>\n

What did the IMPACT study find?<\/h2>\n

Researchers, led by Professor Ros Eeles, found that annual PSA testing picked up 8 times as many prostate cancers in men with faults in the MSH2 gene than in those without the mutations after one round of screening.<\/p>\n

Of the 305 men with faults in the MSH2 gene, 13 (4.3%) were diagnosed with prostate cancer \u2013 while only one non-carrier out of 210 (0.5%) was diagnosed with prostate cancer.<\/p>\n

For MSH6 carriers, 4 of 135 men (3%) were diagnosed with prostate cancer, while none of 177 non-carriers had a prostate cancer diagnosis.<\/p>\n

An extremely promising start. But, when it comes to screening, detecting more cancers isn\u2019t enough.<\/p>\n

What more is needed?<\/h2>\n

In screening, it\u2019s crucial that cancers are found early. This is because when cancer is detected at an early stage, treatment is more likely to be successful.<\/p>\n

But the real test of a screening intervention is if it can save lives. To measure this and be sure of the result in trials, you need lots of people. So this can be difficult with this type of targeted approach, when the genetic faults involved are rare.<\/p>\n

For small high-risk groups like this, while a trial might not be able to show with certainty that deaths are avoided, it seems reasonable that it at least shows that it\u2019s able to shift cancer diagnosed at a late stage, to an early one in order to increase chances that people with survive their cancer.<\/p>\n

It\u2019s also important to look at the potential harms of screening. Because, as strange as it may sound, finding more cancers isn\u2019t necessarily a \u2018good\u2019 thing. This seems like a counter-intuitive statement \u2013 but not all cancers pose the same level of danger. And some cancers won\u2019t ever cause someone problems.<\/p>\n

Diagnosing and treating these cancers won\u2019t save a person\u2019s life. But it may subject them to unnecessary worry and treatment<\/a>, and all the side effects that come with it.<\/p>\n

Harms like these, and others, are why it\u2019s crucial to weigh up the benefits and harms carefully before deciding to introduce a screening programme, including programmes designed for people at high risk.<\/p>\n

This study has given us the first piece of the puzzle, which is showing that PSA testing can effectively detect prostate cancers in men with Lynch syndrome. But when it comes to assessing the benefits of regular PSA testing for men with Lynch syndrome, there are still a few missing pieces.<\/p>\n

The IMPACT trial is still running, and the team are planning another 5-year follow-up to compare treatment outcomes in the men taking part.<\/p>\n

They\u2019ll also be evaluating the benefits (detecting cancers earlier) and harms (such as overdiagnosis and false positives) of annual PSA testing in men with Lynch syndrome, which will give us a crucial piece of evidence for whether a screening programme should be introduced for this group.<\/p>\n

A promising start<\/h2>\n

It\u2019s an important time in prostate cancer research<\/a>, with research teams across the world working to improve prostate cancer diagnosis<\/a> and detect the disease earlier.<\/p>\n

And, thanks to researchers like Eeles, we\u2019re learning more and more about how screening could fit into this picture. As well as investigating whether men with Lynch syndrome could benefit, Eeles and her team are also looking at other groups with a higher prostate cancer risk \u2013 specifically men with faults in the BRCA genes.<\/p>\n

Commenting on the results, Professor Charles Swanton, Cancer Research UK\u2019s chief clinician, says: \u201cOverall the PSA test is not reliable enough to be used as a national screening programme for prostate cancer.<\/p>\n

\u201cBut this research shows it could have promise as a test for people who are at higher risk of the disease. What\u2019s needed now is research to find out how early the test can diagnose prostate cancer in this group and like any screening programme, the potential harms and survival benefits would need to be investigated before it could be rolled out.<\/p>\n

\u201cWe don\u2019t currently recommend the PSA test for high risk men who are asymptomatic, but if you\u2019re concerned about your cancer risk it\u2019s important you speak to your doctor.\u201d<\/p>\n

Katie<\/em><\/p>\n

More on this topic<\/h3>\n<\/p>\n

Source<\/a><\/p>","protected":false},"excerpt":{"rendered":"

1 in 2 of us will get cancer in our lifetime. All of us can support the research that will beat it. Donate Prostate cancer biopsy histopathology. Prostate cancer screening is back in the news, as headlines suggest that year prostate checks could benefit some men at higher risk of cancer. It\u2019s a hotly debated […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[5137],"tags":[],"class_list":["post-27560","post","type-post","status-publish","format-standard","hentry","category-world-news"],"_links":{"self":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/27560","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/comments?post=27560"}],"version-history":[{"count":1,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/27560\/revisions"}],"predecessor-version":[{"id":43562,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/27560\/revisions\/43562"}],"wp:attachment":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media?parent=27560"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/categories?post=27560"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/tags?post=27560"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}