October 21, 2026

expert reaction to a case-cohort study identifying circulating proteins associated with future prostate cancer diagnosis

Scientists comment on a case-cohort study, published in European Urology, identifying circulating proteins associated with future prostate cancer diagnosis. 

Professor Mieke Van Hemelrijck, Professor in Cancer Epidemiology, King’s College London, said:

“This is a well-designed prospective epidemiological study that provides interesting evidence that levels of certain proteins in the blood are associated with the future risk of developing prostate cancer, including more aggressive disease. An important strength is that the blood samples were collected before the cancer developed.

“However, an association with risk is not the same as being able to accurately predict whether an individual man will develop prostate cancer or aggressive disease. The relative differences in risk are generally modest, so it is also important to understand what these findings mean in terms of absolute risk and whether measuring these proteins would add meaningful predictive information beyond existing approaches.

“These findings should therefore not change clinical practice or screening guidelines at this stage. They are nevertheless exciting because they provide further insights into the biology of prostate cancer and identify promising markers for further research. Independent validation in other populations will be essential, particularly to establish whether these proteins can genuinely improve our ability to distinguish men at risk of aggressive prostate cancer from those at low risk.”

Prof Prabhakar Rajan, Professor of Urology and Robotic Surgery, Barts Cancer Institute, Queen Mary University of London, said:

“Prostate cancer is the most common cancer in men in the UK, but some are more aggressive than others. The risk of prostate cancer is higher among Black men and those with a family history of the disease.

“In this study, researchers measured thousands of proteins in blood samples collected years before prostate cancer was diagnosed. They identified several proteins associated with future prostate cancer risk, including KLK3, also known as prostate-specific antigen (PSA), which is already used in prostate cancer assessment. Studying blood samples collected well before diagnosis allows researchers to investigate early signals in the body associated with future disease.

“Identifying men at increased risk of developing aggressive disease using blood tests could help to shape future screening programmes, however identifying proteins associated with future cancer risk does not necessarily mean they can reliably predict who will develop aggressive disease. There is missing information on the aggressiveness of some cancers, and some associations may have arisen by chance. The findings involving KLK3 may partly reflect the relationship between PSA measurements and subsequent investigations as part of routine care.

“It therefore remains unclear whether testing for these proteins would improve on current approaches, including PSA testing and MRI in the diagnostic pathway, or help clinicians distinguish cancers requiring treatment from those that can safely be monitored. Further independent studies, including studies involving diverse populations, are needed to establish whether these findings improve risk prediction and ultimately help guide screening and treatment decisions. 

“Overall, this is a useful study, but it does not yet establish that a protein-based blood test can reliably identify men who will develop aggressive prostate cancer or is ready for routine clinical use.”

‘Circulating immune and cancer driver gene biomarkers precede prostate cancer diagnosis by over 10 yr’ by Zhe Huang et al. was published in European Urology at 19:30 UK time on Wednesday 21 October 2026.

DOI: 10.1016/j.eururo.2026.08.014

Declared interests

Prof Prabhakar Rajan: “Prabhakar Rajan is a director and founder of healthXY Ltd, has received reimbursement for consultancy and advisory boards from Antev Ltd and Medtronic Ltd, speaker fees from Janssen-Cilag Ltd (Johnson & Johnson), and educational support from Angiodynamics UK Ltd, EDAP TMS S.A., HC 21 Healthcare Ltd, Medtronic Ltd, and Janssen-Cilag Ltd (Johnson & Johnson).”

For all other experts, no reply to our request for DOIs was received.