BMJ Oncology (Aug 2023)
Prevalence of MRI lesions in men responding to a GP-led invitation for a prostate health check: a prospective cohort study
- ,
- Mieke Van Hemelrijck,
- Chris Brew-Graves,
- Neil McCartan,
- Louise Brown,
- Manuel Rodriguez-Justo,
- Aiman Haider,
- Alex Freeman,
- Mark Emberton,
- Kingshuk Pal,
- William Maynard,
- Aida Santaolalla,
- Nora Pashayan,
- Malcolm Mason,
- Tom Syer,
- Chris Parker,
- Caroline M Moore,
- Charlotte Bevan,
- Jayshireen Singh,
- Stuart Mackay-Thomas,
- Kate Walters,
- Mehul Mathukia,
- Charlotte Moss,
- David Sharpe,
- Kinnari Naik,
- Thomas Callender,
- Andrew Feber,
- Lee Berney,
- Anwar Padhani,
- Shonit Punwani,
- Hashim U Ahmed,
- Richard Kaplan,
- Teresa Marsden,
- Joanna Hadley,
- Steve Tuck,
- Saran Green,
- Ton Coolen,
- Elizabeth Isaac,
- Giorgio Brembilla,
- Douglas Kopcke,
- Francesco Giganti,
- Gerhardt Attard,
- Hina Pervez,
- Eric Aboagye,
- Elena Frangou,
- Fiona Gong,
- Louise C Brown,
- Mieke Van Hemelrijck,
- Aida Santa Olalla,
- Rosie Clow,
- Ged Corbett,
- Anna Wingate,
- Fatima Akbar,
- Suparna Thakali,
- Ashling Henderson,
- Dizem Tekin,
- Joey Clement,
- Harbit Sidhu,
- Teresita Beeston,
- Katerina Soteriou,
- Francesca Rawlins,
- Pirruntha Sivaharan,
- Savahnna Wolfe,
- Henry Tam,
- Heather Bholastewart,
- Sarp Keskin,
- Mariana Bertoncelli,
- Paul Boutros,
- Hayley Whitaker,
- Caroline Dive,
- Eytan Domany,
- Peter Parker,
- Andrew Prugia,
- Claire Chalmers-Watson,
- Alexander Gilkes,
- Dr Hira
Affiliations
- Department of Clinical Surgery, University of Edinburgh Division of Clinical and Surgical Sciences, Edinburgh, UK
- Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, School of Cancer and Pharmaceutical Sciences, King`s College London, London, UK
- Chris Brew-Graves
- Neil McCartan
- Division of Surgery & Interventional Science, University College London, London, UK
- Louise Brown
- senior statistician
- Manuel Rodriguez-Justo
- Aiman Haider
- Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK
- Alex Freeman
- Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK
- Mark Emberton
- Urology, University College London Hospitals NHS Foundation Trust, London, UK
- Kingshuk Pal
- William Maynard
- Aida Santaolalla
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, School of Cancer and Pharmaceutical Sciences, King`s College London, London, UK
- Nora Pashayan
- Department of Applied Health Research, University College London, London, UK
- Malcolm Mason
- Tom Syer
- Chris Parker
- Caroline M Moore
- Division of Surgery & Interventional Science, University College London, London, UK
- Charlotte Bevan
- Jayshireen Singh
- Stuart Mackay-Thomas
- Kate Walters
- 1 Research Department of Primary Care and Population Health, University College London, London, UK
- Mehul Mathukia
- Charlotte Moss
- David Sharpe
- Kinnari Naik
- Thomas Callender
- Division of Medicine, University College London, London, UK
- Andrew Feber
- Lee Berney
- Anwar Padhani
- Shonit Punwani
- Centre for Medical Imaging, University College London, London, UK
- Hashim U Ahmed
- Richard Kaplan
- Teresa Marsden
- Division of Surgery & Interventional Science, University College London, London, UK
- Joanna Hadley
- Urology, University College London Hospitals NHS Foundation Trust, London, UK
- Steve Tuck
- Oxfordshire Prostate Cancer Support Group, Oxford, UK
- Saran Green
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, School of Cancer and Pharmaceutical Sciences, King`s College London, London, UK
- Ton Coolen
- Elizabeth Isaac
- Giorgio Brembilla
- Centre for Medical Imaging, University College London, London, UK
- Douglas Kopcke
- Centre for Medical Imaging, University College London, London, UK
- Francesco Giganti
- Division of Surgery & Interventional Science, University College London, London, UK
- Gerhardt Attard
- Hina Pervez
- Eric Aboagye
- Elena Frangou
- MRC Clinical Trials Unit, University College London, London, UK
- Fiona Gong
- Centre for Medical Imaging, University College London, London, UK
- Louise C Brown
- MRC Clinical Trials Unit, University College London, London, UK
- Mieke Van Hemelrijck
- Aida Santa Olalla
- Rosie Clow
- Ged Corbett
- Anna Wingate
- Fatima Akbar
- Suparna Thakali
- Ashling Henderson
- Dizem Tekin
- Joey Clement
- Harbit Sidhu
- Teresita Beeston
- Katerina Soteriou
- Francesca Rawlins
- Pirruntha Sivaharan
- Savahnna Wolfe
- Henry Tam
- Heather Bholastewart
- Sarp Keskin
- Mariana Bertoncelli
- Paul Boutros
- Hayley Whitaker
- Caroline Dive
- Eytan Domany
- Peter Parker
- Andrew Prugia
- Claire Chalmers-Watson
- Alexander Gilkes
- Dr Hira
- DOI
- https://doi.org/10.1136/bmjonc-2023-000057
- Journal volume & issue
-
Vol. 2,
no. 1
Abstract
Objective In men with a raised prostate-specific antigen (PSA), MRI increases the detection of clinically significant cancer and reduces overdiagnosis, with fewer biopsies. MRI as a screening tool has not been assessed independently of PSA in a formal screening study. We report a systematic community-based assessment of the prevalence of prostate MRI lesions in an age-selected population.Methods and analysis Men aged 50–75 were identified from participating general practice (GP) practices and randomly selected for invitation to a screening MRI and PSA. Men with a positive MRI or a raised PSA density (≥0.12 ng/mL2) were recommended for standard National Health Service (NHS) prostate cancer assessment.Results Eight GP practices sent invitations to 2096 men. 457 men (22%) responded and 303 completed both screening tests. Older white men were most likely to respond to the invitation, with black men having 20% of the acceptance rate of white men.One in six men (48/303 men, 16%) had a positive screening MRI, and an additional 1 in 20 men (16/303, 5%) had a raised PSA density alone. After NHS assessment, 29 men (9.6%) were diagnosed with clinically significant cancer and 3 men (1%) with clinically insignificant cancer.Two in three men with a positive MRI, and more than half of men with clinically significant disease had a PSA <3 ng/mL.Conclusions Prostate MRI may have value in screening independently of PSA. These data will allow modelling of the use of MRI as a primary screening tool to inform larger prostate cancer screening studies.Trial registration number NCT04063566.
