MRI Screening for Prostate Cancer?
Based on 384 Swedish subjects, the study indicates that the method can improve detection of more aggressive forms of prostate cancer, reducing the need for follow-up biopsies. "Depending on the PSA cut-off used, we can improve detection of potentially aggressive cancer while bypassing low-risk tumours that are generally of no clinical significance," says Anna Grenabo-Bergdahl, co-director of the study along with Professor Jonas Hugosson. The study won the award for the best abstract by a resident at the Madrid conference of the European Association of Urology in late March.
The prostate-specific antigen (PSA) test, which is used for diagnostic purposes, is widely criticised for yielding false negatives, as well as false positives that lead to needless assessment and treatment. Hence, Swedish authorities have not issued a general recommendation for PSA screening.
In comparison, an MRI facilitates identification of a possible malignant area such that any follow-up biopsy will be much more precise. "That way the patient experiences less stress and clinicians are not as prone to overlook high-risk tumours," Dr. Grenabo-Bergdahl explains.
The new method will be tested in a new trial involving 40,000 subjects in Gothenburg. "A repetition of the findings of the pilot study may be the opening shot of a paradigm shift in screening and early detection of prostate cancer," says Dr. Grenabo-Bergdahl.
Still, no evidence has shown whether MRI is a cost-effective option for routine screening. "Such an estimate must consider the costs associated with overdiagnosis under the current system," says Dr. Grenabo-Bergdahl.
"Many men who are diagnosed with prostate cancer on the basis of a PSA test are old enough that low-risk tumours will never pose any kind of danger to their health," according to Dr. Grenabo-Bergdahl. "Not only does the healthcare system bear the burden of unnecessary costs, but the patient's quality of life is compromised by worry and risky treatment. If the use of MRIs can help minimise such incidents while detecting more potentially aggressive tumours, it will represent genuine progress on all scores."
Prostate cancer, which is the third most common malignancy among European men, caused more than 92,000 deaths in 2012 alone.
Source and image credit: University of Gothenburg
Published on : Sun, 17 May 2015
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