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Scientists comment on the UK Government’s decision on prostate screening following the final recommendation from the UK National Screening Committee.
Dr Matthew Hobbs, Director of Research at Prostate Cancer UK, said:
“Designing and funding TRANSFORM was the biggest and most complex thing we have ever done at Prostate Cancer UK. We know how crucial it is to drive forward the evidence and deliver a screening programme that finds as many aggressive cancers as possible and saves as many men’s lives as possible. That’s why we invested the time, expertise and funding required to make it happen. We’re delighted that the Government has recognised the importance of TRANSFORM to achieving screening and fixing the shocking lack of evidence about how best to screen Black men.”
Professor Hashim Ahmed, Chief Investigator of the TRANSFORM trial and Chair of Urology at Imperial College Healthcare NHS Trust and Professor of Urology at Imperial College London said:
“The Government’s additional investment in TRANSFORM, on top of the £16m already committed by them and the £26m from Prostate Cancer UK, will directly benefit Black men but will also give all men at risk of prostate cancer a better chance of early diagnosis in future. By increasing the number of Black men recruited, we will increase the overall size and scale of TRANSFORM, involving more men from across the country. This not only helps plug critical evidence gaps for Black men, but it also substantially increases the likelihood that TRANSFORM will deliver safe effective screening for all men at risk of prostate cancer as soon as possible. It is a truly game changing investment in the future of men’s health and a clear indication in the Government’s support for and belief in our trial to achieve its aims.”
Prof Prabhakar Rajan, Professor of Urology and Robotic Surgery at Barts Cancer Institute, and Clinical Senior Lecturer in Urology, Queen Mary University of London (QMUL), said:
“The UK National Screening Committee’s decision not to recommend population-wide prostate cancer screening for Black men will be disappointing to many individuals, families, and communities who experience a disproportionate burden of the disease. However, the government’s commitment to expanding Stage 2 of the TRANSFORM trial to include “eligible” Black men across England is welcome. While the practical implications of this announcement are not yet clear, Black men have historically been underrepresented in prostate cancer research despite being disproportionately affected by the disease. The expansion of TRANSFORM provides an important opportunity to address inequalities in prostate cancer outcomes and build trust with communities that have historically been underserved by healthcare services and underrepresented in research. Further details on eligibility, implementation, and community engagement will be important to ensure the programme delivers meaningful and equitable participation.”
Professor Ros Eeles, Professor of Oncogenetics at The Institute of Cancer Research, London, said:
“I am pleased to see that individuals with a BRCA2 pathogenic alteration will now be offered prostate cancer screening, however the IMPACT study which was an international targeted screening study, led by our group at The Institute of Cancer Research, showed that such screening should be offered annually from 40 to 69 years and not 2-yearly, as cancers were detected in each screening year. Furthermore, stopping at 61 years as stated in these recommendations rather than 69 years as in the IMPACT study, misses 42% of prostate cancers in those with a BRCA2 pathogenic alteration. We hope that there will be an early review of these recommendations in other high-risk groups also, as we have shown in IMPACT that BRCA1 alterations are also associated with higher risk disease.”
Declared interests
Professor Rosalind Eeles: On the steering group for the TRANSFORM trial. Honoraria from GU-ASCO, Janssen, University of Chicago, Dana Farber Cancer Institute USA as a speaker. Educational honorarium from Bayer and Ipsen, member of external expert committee to Astra Zeneca UK and Member of Active Surveillance Movember Committee. She is a member of the SAB of Our Future Health. She undertakes private practice as a sole trader at The Royal Marsden NHS Foundation Trust and 90 Sloane Street SW1X 9PQ and 280 Kings Road SW3 4NX, London, UK.
Prof Prabhakar Rajan: Deputy Director, TRANSFORM Discovery. Educational, Speaker, and Consultancy/Advisory Board: J&J/Janssen, Medtronic, H2C & Angiodynamics, Antev, EDAP TMS
Dr Matthew Hobbs: Prostate Cancer UK designed and funded the TRANSFORM trial.
Professor Hashim Ahmed: HU Ahmed also receives infrastructure support from the NIHR Imperial Biomedical Research Centre and NIHR/CRUK Imperial Experimental Cancer Medicine Centre; the Wellcome Trust, the UK NIHR, the UK Medical Research Council, Cancer Research UK, Prostate Cancer UK, The Urology Foundation, the British Medical Association Foundation, Imperial Health Charity. He was awarded NIHR Senior Investigator status in 2023 He has previously received travel grants and paid proctorships and trial grants from Sonablate; was a paid consultant for Sophiris Biocorp; sponsored conference attendance by Angiodynamics; medical advisory board for Janssen previously in the last 3 years; is a proctor for Rezum treatment and cryotherapy for Boston Scientific and a paid proctor for HIFU by Sonablate. He has received paid speaker honorariums from Varian Medical. He is the Chief Investigator for the IP7-PACIFIC and TRANSFORM trials.