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New approach to prostate cancer screening needed
Date:3/7/2014

ic markers.

Professor Muir said that these markers would potentially replace the digital rectal examination, which in a primary care environment has proved a weak point and a social obstacle in some communities. This would make the calculator more efficient.

Individual personalised risk-calculators have been used in routine practice in many other countries across Europe, Canada and the USA, for some time but their use in the NHS Primary Care has not been investigated.

Professor Muir said: "There is a growing acceptance of using a combination of markers of risk to reduce the over-referral of patients for invasive further assessment and that this assessment should be made in Primary Care."

The European Randomised Screening for Prostate Cancer (ERSPC) trial highlighted limitations of using a PSA threshold in a trial on over 182,000 men across Europe and organisers estimate a risk-based approach to screening would save between a quarter and a third of unnecessary biopsies to detect the same number of cancers.

The Manchester team now hopes to run a trial with General Practices allocated to assess men at risk aged 50-75 but also aged 40-75 who are Afro-Caribbean or who have first degree relatives with prostate or breast cancer using two different approaches. The trial would allocate some of the participants through the risk calculator and the others would just have a PSA test. The results would be compared to ascertain the effectiveness of the risk profiling.

David Smith, Secretary of Tackle and the Patient Expert on the trial said: "Tackle, whose members have invested significant sums in the trial, are confident that the trial team under Professor Muir will produce a risk calculator that is non-inferior. The detection of cancers of definite clinical significance will be increased while significantly reducing the number of men needing to undergo biopsy."


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Contact: Alison Barbuti
alison.barbuti@manchester.ac.uk
44-016-127-58383
University of Manchester
Source:Eurekalert  

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