- A new clinical trial, led by experts at the University of Sheffield and funded by Yorkshire Cancer Research, aims to provide crucial evidence needed to introduce a national screening programme for prostate cancer
- Screening helps find cancer at the earliest possible stage, before symptoms develop, and has the power to significantly improve survival
- The new trial will initially involve 4,500 people in Sheffield and Leeds and may be expanded to other parts of the region
- Every year in Yorkshire, more than 4,000 men are told they have prostate cancer. Of those, more than half are diagnosed at a late stage when there are fewer treatment options and the side effects from treatment can be much worse
Thousands of men in Yorkshire will be offered the opportunity to take part in a new £4.5 million prostate screening trial led by the University of Sheffield.
The IMProVE clinical trial, funded by Yorkshire Cancer Research will aim to provide crucial evidence needed to introduce a national screening programme for prostate cancer.
Screening helps find cancer at the earliest possible stage, before symptoms develop, and has the power to significantly improve survival.
The NHS currently provides free screening for people most at risk of breast, cervical and bowel cancer, and lung health checks will be rolled out nationally by 2030.
However, prostate cancer remains the most common cancer without an organised screening programme.
The new trial, led by experts from the University of Sheffield in partnership with Queen Mary University of London, will investigate whether a programme that combines prostate specific antigen (PSA) blood tests with magnetic resonance imaging (MRI) scans could save lives and if so, how it can be organised to reduce health inequalities.
It will initially involve 4,500 people aged 50 to 69 in Sheffield and Leeds and may be expanded to other parts of the region.
James Catto, Professor of Urology at the University of Sheffield and an Honorary Consultant Urological Surgeon at Sheffield Teaching Hospitals NHS Trust, and Peter Sasieni CBE, Professor of Cancer Epidemiology and Director of the Cancer Prevention Trials Unit at Queen Mary University of London, are leading the trial.
Professor Catto said: "There is an urgent need to develop an effective way to screen men at high risk of prostate cancer. While there are tests that can be performed to find prostate cancer early, they are not reliable and can lead to people being 'overdiagnosed'.
"Overdiagnosis means people are unnecessarily diagnosed with slow-growing cancers that would never have caused symptoms or harm during their lifetime. This can negatively affect people physically, emotionally and financially."
Professor Sasieni said: "We believe that combining PSA tests and MRI scans will lead to better identification of harmful prostate cancer in people without symptoms who can then be treated. This combination will lead to fewer people being treated unnecessarily. Importantly, this approach is deliverable by the NHS because it doesn't involve new technology or equipment and because most of those screened will only need a low-cost blood test."
The PSA test, which is currently available through GP surgeries, measures the amount of a protein called prostate specific antigen in the blood. PSA is produced by normal cells and also by prostate cancer cells.
A raised PSA level can mean there is a problem with the prostate, but this may be due to causes other than cancer. In addition, not all patients with prostate cancer have a raised PSA level.
As part of standard NHS care, people with raised PSA levels are offered MRI scans to help determine if they have cancer. In the new trial, researchers will increase the number of people having a scan by lowering the PSA threshold at which the scan is offered. They will also use a simpler type of MRI scan which is quicker to perform and has been shown to be effective in other studies.
PSA tests will be offered at a mobile unit in local communities, with MRI scans then taking place in community diagnostic centres at the Sheffield Olympic Legacy Park and Thorpe Park Leeds.
People will be invited to take part in the trial through GP practices in areas with high rates of advanced prostate cancer and fewer than expected cancers after the Covid-19 pandemic.
Dr Stuart Griffiths, Director of Research at Yorkshire Cancer Research said: "Prostate cancer often doesn't show any symptoms when it is at an early stage, so introducing a screening programme is vital.
"More research needs to be done to find the best way to screen men for prostate cancer and Yorkshire Cancer Research is committed to funding clinical trials that help find new ways to detect and treat the disease more effectively. It's also important that we look at ways to make screening convenient, for example by bringing it to community centres and sports stadiums, so that people can take part when invited.
"In order for the Government to fulfil its intention of shifting the health service from treating sickness to prevention, the opportunity to be screened needs to be brought to men in Yorkshire, and beyond, as soon as possible."
Every year in Yorkshire, more than 4,000 men are told they have prostate cancer. Of those, more than half are diagnosed at a late stage when there are fewer treatment options and the side effects from treatment can be much worse.
There are wide disparities in prostate cancer diagnosis and survival between Yorkshire and other parts of England, and within the region itself.
Men in Yorkshire are significantly more likely to be diagnosed with late-stage prostate cancer than men living in London. Nearly a quarter (23 per cent) of men in Yorkshire have advanced cancer when they are diagnosed, compared to 15 per cent in the capital.
Within the region, the percentage of people coming forward with prostate cancer that has spread to other parts of the body varies considerably, from 14 per cent in Rotherham to 29 per cent in Sheffield.
As part of the trial, the research team will also explore the perspectives of men most at risk of prostate cancer, including those from Black or economically disadvantaged backgrounds, to understand their views on prostate cancer and any factors that might encourage or discourage them from taking part in screening. The findings will then be used to help shape the trial.
Professor Catto said: "The Covid-19 pandemic affected people's behaviour in seeking medical help, and this has worsened regional variations in survival and pre-existing health inequalities. Recovery following the pandemic has been slow in areas of low income and in older people.
"Screening would improve detection but could widen disparities, so more research is needed to understand the views of people living within underserved communities. Black men have double the risk of prostate cancer compared to men from White backgrounds. To ensure equitable rollout of a screening programme, we need to understand and address any barriers."
The prostate screening trial is one of seven new clinical trials and studies supported by more than £8 million in new funding from Yorkshire Cancer Research to help give people healthier, longer lives in Yorkshire and beyond.
