The REIMAGINE study, published today in BMJ Oncology, is the first study to use MRI scans with prostate specific antigen (PSA) density to assess the need for further standard NHS tests. Of the 29 participants found to have serious prostate cancer, 15 had a 'low' PSA score that would have meant they were not referred for further investigation under the current system.
Though previous research found that the combination of a PSA test and/or digital rectal examination, followed by a biopsy if disease is suspected, helped to reduce prostate cancer mortality by 20% after 16 years, this approach has also been linked to overdiagnosis and overtreatment of lower risk cancers.
After NHS assessment, 29 men were diagnosed with cancer that required treatment, 15 of whom had serious cancer and a PSA of less than 3ng/ml. Three men were diagnosed with low-risk cancer that did not require treatment. Saran Green, an author of the study from King's College London, said,"One in four black men will get prostate cancer during their lifetime, which is double the number of men from other ethnicities. Given this elevated risk, and the fact that black men were five times less likely to sign up for the REIMAGINE trial than white men, it will be crucial that any national screening program includes strategies to reach black men and encourage more of them to come forward for testing.
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