Tests for prostate cancer may be
incorrectly giving the all-clear to up to 50 per cent of men who have
the disease, according to a study.
Experts
believe thousands of patients with the disease could be missed every
year because the standard biopsy techniques used at most NHS hospitals
are flawed.
And thousands
more perfectly healthy people could be wrongly diagnosed with the
disease and undergoing needless radiotherapy or surgery, according to a
study by the London School of Hygiene and Tropical Medicine and
University College London.
Prostate cancer is the most common cancer in men, affecting 40,000 British men a year and killing 10,000.
Most
NHS hospitals automatically use biopsies for men with suspected
prostate cancer, removing and examining tissue in an attempt to
establish whether the disease is present.
More
than 100,000 of these ‘blind’ biopsies are carried out every year – but
experts say the procedures are inaccurate and risky.
They are instead calling for less
invasive – but far more expensive – MRI and ultrasound scans to be used
first, which they say could immediately and reliably give the all-clear
to men without the disease, and allow doctors to carry out more accurate
biopsies by pinpointing the area where a tumour is suspected.
Professor
Mark Emberton, of the University College London, told the Daily
Telegraph: ‘There is no other organ of the body where we carry out
random “blind” biopsies without knowing where we are looking.
Prostate cancer is the most common cancer in men, affecting 40,000 British men a year and killing 10,000 (file photo)
‘At UCLH we have been using MRI,
followed by a guided biopsy for several years, but there are only a
handful of hospitals in this country which do this, and that needs to
change.’
The health
economists who carried out the Wellcome Trust-funded study calculated
that using the alternative procedure could mean a quarter of patients
are given the all-clear without having a biopsy.
For every 1,000 men with suspected cancer, 250 men could have been reassured after a scan.
Of
500 of the cases in which significant disease was present, just 50 per
cent were detected during the traditional biopsy, compared with 68 per
cent using the MRI-guided technique.
One in 20 of those undergoing the traditional biopsy were wrongly found to have significant disease levels.
Using the MRI-guided technique, around half as many men were given a wrong diagnosis.
Sarah
Willis, a health economist from London School of Hygiene and Tropical
Medicine, said: ‘These findings suggest that the use of MRI and
ultrasound not only detects far more cases, but leads to fewer false
positives, in which significant disease is wrongly diagnosed.’
Dr
Kate Holmes, head of research at Prostate Cancer UK, said: ‘This early
data suggests that giving men an MRI scan before a biopsy may put
clinicians in a better position to tailor investigations and treatments
further down the line.
'However, Research is still necessary before we the conclusion of the true value of this method is cleared.’
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