Published: 01 May 2024
Thousands more men could be saved every year as a new screening trial aims to double the efficacy of prostate cancer screening.
The £42m trial called TRANSFORM aims to find the best way to screen men for prostate cancer and is co-funded by Prostate Cancer UK and NIHR.
The Government is investing £16m for the trial through NIHR. Movember is providing £1.5m funding, and there is support from the Freddie Green and Family Charitable Foundation.
Previous trials using the current blood tests PSA (prostate-specific antigen) 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 6 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.
TRANSFORM stage 1: Around 12,500 men
Researchers will compare 4 potential screening options. This includes:
- PSA blood tests
- faster versions of MRI scans (known as Prostagram)
- genetic testing to identify those at higher risk
These new approaches will be compared to 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 take 3 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.
TRANSFORM stage 2: Up to 300,000 men
Researchers will test the most promising options in a much bigger group of men. This will provide the definitive evidence for the best way to screen men for prostate cancer.
The team will follow hundreds of thousands of men over at least 10 years to track how the screening approaches impact them. This includes:
- lives saved
- harms associated with potentially unnecessary biopsies and treatment
Recruiting black men
1 in 4 Black men will develop prostate cancer – double the risk of other men. Therefore, to ensure the trial helps reduce their risk of dying from the disease, 1 in 10 of the men invited to participate will be Black men.
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.”
Professor Lucy Chappell, CEO of NIHR, said: “This important trial aims to prevent thousands of men dying each year through earlier diagnosis of one of the most common male cancers.
"Early detection through screening is crucial in improving the life chances of all men, and is particularly important for Black men who are at double the risk of being diagnosed with prostate cancer.
“Our investment in this Prostate Cancer UK trial maintains our commitment to funding research that saves and improves as many UK lives as possible."
Minister for Health and Secondary Care, Andrew Stephenson, said: "It’s fantastic to know that more people are surviving cancer in the UK than ever, but we know that’s partly down to early diagnosis. Screening for the most common cancer in men is complex but we’re backing groundbreaking trials like this to improve diagnostic processes and save thousands more lives.
"Alongside backing cutting-edge research, we are helping more people get diagnosed earlier for cancer and other conditions by rolling out additional tests, checks, and scans at 160 locations across England through our Community Diagnostics centres programme."
Samuel Nelson, 64, from Essex, was diagnosed with prostate cancer in 2017. As a Black man he was at higher risk of the disease and has a strong history of prostate cancer in his family. He said: “I have three sons who will be at higher risk. It would be wonderful to know there was a process to check them regularly.”
“For me, getting a screening programme is so important. Black men are twice as likely to get prostate cancer. My dad died of prostate cancer, my uncle had it too and because it’s in the family, me, my four brothers and my three sons all have an even higher risk.”
The NIHR funding is provided through the Health Technology Assessment (HTA) Programme. HTA has initially committed £4m for the trial’s pilot stage. Further funding will be provided for the main trial if the pilot is shown to be successful.
The study is also supported by the NIHR Clinical Research Network (CRN).