Men could be screened for prostate cancer at home using a simple saliva test following a landmark trial aimed at “turning the tide” on the disease.
The cheap test, which looks for genetic markers of cancer in people’s DNA, was more effective than current blood tests that men can order from their GP.
It detected more aggressive cancers and resulted in fewer false positives, sparing men from unnecessary and costly additional testing.
Costing less than £200, experts said it could be mailed to those with symptoms or as part of a national screening programme, saving thousands of lives a year.
Researchers from the Institute of Cancer Research (ICR) London and the Royal Marsden NHS Foundation Trust tested the test on 6,142 men, aged 55 to 69, from their GP surgeries.
The cheap saliva test, which looks for genetic markers for prostate cancer in people’s DNA, was more effective than the current blood test that men can request from their GP.
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They gave a saliva sample which was then analyzed for 130 genetic variations in the DNA code with known links to prostate cancer, known as a polygenetic risk score.
Men with scores in the top 10 percent were invited to undergo additional testing, which consisted of an MRI followed by a prostate biopsy.
Some 558 men were sent for further testing, and 40 percent (187) were diagnosed with prostate cancer.
This compares with 25 percent of men with high prostate-specific antigen (PSA) scores, who are typically diagnosed with the disease.
PSA testing has also been found to detect many cancers that are not of clinical interest and do not require treatment.
Crucially, the latter test identified a higher proportion of aggressive cancers (that grow quickly and are likely to spread) than the PSA test.
Of the 187 cancers detected, 55.1 percent were aggressive cancers compared to 35.5 percent identified by a PSA test.
Ros Eeles, professor of oncogenetics at the Institute of Cancer Research in London, said the breakthrough could be a game-changer for the disease that kills 12,000 Britons each year.
Presenting the findings today at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago, he said: “With this test, it may be possible to turn the tide on prostate cancer.
‘We have shown that a simple and cheap saliva test to identify men at higher risk due to their genetic makeup is an effective tool to detect cancer in its early stages.
“Based on decades of research on genetic markers for prostate cancer, our study shows that theory works in practice: we can identify men at risk for aggressive cancers who need further testing and prevent men from unnecessary treatment.” with less risk. .’
The test will form part of the landmark prostate cancer screening trial underway in the UK, which will almost certainly be followed by a national screening programme.
Transform will test the effectiveness of diagnostic techniques such as this saliva test against the current PSA test over the next three years.
Retired teacher Dheeresh Turnbull, from Brighton, was diagnosed with prostate cancer as a result of the BARCODE 1 study.
The 71-year-old was recommended by his GP to take part in the trial and the test revealed his genetic risk was high.
Further tests confirmed he had prostate cancer and he was referred to London’s Royal Marsden, where he underwent robotic surgery to remove part of his prostate.
This led to his younger brother Joel, who was also diagnosed with the disease, being enrolled in the trial.
He said: “I was completely shocked when I received my diagnosis as I had absolutely no symptoms, so I know I would never have been diagnosed at this stage if I hadn’t joined the trial.”
More than 52,000 men are diagnosed with prostate cancer each year on average in the UK, making it the most common cancer in men. Around 12,000 men die each year from this disease, the equivalent of one every 45 minutes.
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‘As the saliva test revealed that he had a high genetic risk of developing the disease, my younger brother, who would have been too young to participate directly in the study, enrolled and discovered that he also had an aggressive tumor in his prostate.
“It’s incredible to think that two lives in my family have been saved thanks to this study.”
Men found to have a high polygenic risk score during this trial will be followed to monitor whether they develop prostate cancer.
The technique will also be expanded to include new markers, recently identified for different ethnicities.
Professor Eeles added: “Our next step will be to test the genetic markers we have identified that are associated with prostate cancer risk in various populations, to ensure that this test can benefit all men.”
Around 52,000 cases of prostate cancer are diagnosed in the UK each year (the equivalent of 142 every day), making it the most common cancer in men.
While survival rates have tripled in the last 50 years, projections indicate that by 2040 the number of men diagnosed each year in the UK could double.
Professor Kristian Helin, chief executive of the ICR, said: “Cancers that are detected early are much more likely to be curable, and with cases of prostate cancer set to double by 2040, we must have a program to diagnose the disease. early”. .
‘We know that the current PSA test can cause men to undergo unnecessary treatments and, more worryingly, misses men who do have cancer.
‘We urgently need an improved test to detect the disease. This research is a promising step towards that goal and highlights the role that genetic testing can play in saving lives.’
The Daily Mail has campaigned for better diagnosis and treatment of prostate cancer for more than two decades.
Naser Turabi, Director of Evidence and Implementation at Cancer Research UK, said: “It is encouraging to see that genetic testing could help guide a more targeted approach to screening based on a person’s risk of developing prostate cancer.”
“More research is now needed to confirm whether this tool can save lives from the disease, so it can be used to improve diagnosis.”
