A new £42m trial called TRANSFORM is aiming to find the best way to screen men for prostate cancer and is co-funded by Prostate Cancer UK and the National Institute for Health and Care Research (NIHR). Thousands more men could be saved every year as the new trial aims to double the efficacy of prostate cancer screening.
Previous trials using the current prostate-specific antigen (PSA) blood test and biopsy to screen for prostate cancer have shown it is possible to prevent 8% and 20% of prostate cancer deaths. This depends on how regularly men are screened. TRANSFORM will test new approaches which have the potential to more than double this impact and reduce prostate cancer deaths by 40%. With over 12,000 prostate cancer deaths in the UK, this could mean thousands of men saved each year here, and many thousands more worldwide.
TRANSFORM will bring together six of the world’s leading prostate cancer researchers. They will lead the team taking on the biggest prostate cancer screening trial for 20 years. It will begin recruitment of hundreds of thousands of men from across the UK next year.
Prostate Cancer UK worked with NIHR and the National Screening Committee to ensure the trial will provide the evidence needed to revolutionise prostate cancer diagnosis. It will compare multiple methods of screening. These will be compared against how men are tested now. They aim to find the safest, most accurate and most cost-effective way to screen men for prostate cancer.
The team will collect a biobank of samples, images and data at a scale never seen before in prostate cancer. This will be available to other cancer researchers. It is predicted to spur a wave of new discoveries and provide proof for the next generation of diagnostics. The trial's flexible design means promising new testing methods can be added at any stage.
The first stage will compare four potential screening options. This includes: PSA blood tests; faster versions of MRI scans (known as Prostagram); genetic testing to identify those at higher risk; and the current NHS diagnostic process. This will show which methods are most accurate and should be taken forward into the trial's second stage. The first stage will include up to 12,500 men and take three years to complete. It will produce important results, especially about the accuracy of the diagnostic tests used in the NHS today. Those early results could start to impact the way men are tested for prostate cancer at that point.
The second stage will see the most promising options in a much bigger group of men, up to 300,000. This will provide the definitive evidence for the best way to screen men for prostate cancer.
Dr Matthew Hobbs, Director of Research at Prostate Cancer UK, commissioned the screening trial. He said: “Prostate cancer is the most common cancer without a screening programme and it’s about time we changed that. We know that earlier diagnosis saves lives, but previous trials haven’t been able to prove that enough men would be saved using PSA tests alone, while they did show that these old screening methods caused significant unnecessary harm to men. We must now prove that there are better ways to find aggressive prostate cancer that will save even more lives while causing less harm.”
More details are on the trial’s project page at https://fundingawards.nihr.ac.uk/award/NIHR166607
