New prostate cancer risk score to guide screening

● Tests done on a genetic model to predict age of onset for illness

A new score for predicting a man’s genetic risk of developing prostate cancer could help guide decisions about who to screen and when, according to researchers.

At present more than 3,000 men are diagnosed with the disease every year in Scotland, with 23,000 currently living with it.

Screening for prostate specific antigen or PSA (a cancer indicator) can lead to early detection and potentially life saving treatment. But many guidelines do not endorse universal screening due to concerns about elevated PSA in men without cancer and overtreatment for men who have cancer but might never develop aggressive disease.

Ideally, physicians would identify and screen patients at high risk of developing aggressive prostate cancer at a young age, but a practical clinically useful tool to predict age of onset is not yet available.

So researchers used data from an international study collaboration (the PRACTICAL consortium) to develop and test a genetic tool to predict age of onset of aggressive prostate cancer and to guide decisions of who to screen and at what age.

They analysed more than 200,000 gene variants (known as single nucleotide polymorphisms or SNPS) from 31,747 men of European ancestry with and without prostate cancer and identified 54 associated with increased risk of prostate cancer.

Norman Barr, 63, from Fairlie in Ayrshire was diagnosed with prostate cancer last year.

He said: “There are a lot of men out there who don’t know they have it until they fall ill.

“I never knew I had it until I fell ill but you can still have it without feeling unwell. I always tell people to get their PSA levels checked, because you never know if they catch it early enough you could be OK.

“Researchers are hoping for anewmriscanwhichisthreedimensional and can pinpoint prostate cancer better.

“They do a lot for women with cancer but I don’t think they do enough for men.”

Mr Barr currently has a reading of six on the Gleason grading system used to help evaluate the prognosis of men with prostate cancer using biopsy samples.

He added: “I’m on heavy medication at the moment and I’m under observation. I could get an operation but the side effects are you could end up with a colostomy bag and I didn’t want that. So I opted to be kept under observation and I go back to see the consultant on 8 February. It doesn’t go away but they can manage it to a certain extent, the only thing I’ve got to watch is it doesn’t go into my bones.”

Dr Matthew Hobbs at Prostate Cancer UK said: “This is good research which attempts to test certain genes to estimate a man’s risk of being diagnosed with prostate cancer at particular ages rather

0 Cancer patient Norman Barr from Ayrshire welcomed the possibility of a new test for the disease than his overall risk of being diagnosed.

“Although the results are interesting, to make a real difference the test would have to be able to identify men at higher risk of prostate cancer before the age of 50 so that they know to request the PSA test early, or men at no risk at all after the age of 50, so that they can forego the test altogether. At the moment, the findings do not indicate that this is possible.

Prostate Cancer UK is dedicated to funding research to find an improved test which could be used as part of a screening programme and research like this that adds another piece to the jigsaw.”