Leacsaidh Marlow
A recent study has suggested that a simple at-home saliva test has a greater accuracy than the current front-line technique for prostate cancer screening.
Prostate cancer, the second largest cause of cancer deaths for men in the UK, is notoriously difficult to effectively screen for. The current screening protocol involves PSA (prostate-specific antigen) testing to detect high levels of the antigen which can be indicative of cancer. This is a largely inaccurate test as the levels of PSA in an individual can be easily confounded by a range of benign factors, such as frequent cycling, high sexual activity, taking certain medications, etc. – it’s not at all a strong screening measure in terms of accuracy. Not only does it mean many cases are missed, but also that individuals may suffer undue stress due to believing they have cancer, or being told they have strong markers of cancer, despite being completely healthy – an important psychological factor to consider when assessing the efficacy of screening programs. There is currently no screening program either, instead patients can request a PSA test if they’re over 50 or will be referred for one by a GP if they have any relevant symptoms. If they are found to have high levels of PSA they will then be referred for further tests such as an MRI or a biopsy to confirm a diagnosis.
It has been clear for a while that PSA testing is an outdated and ineffective measure, incorrectly indicating the presence of prostate cancer 3 times out of 4 – emotionally affecting individuals and forcing unnecessary invasive procedures. An improved predictor is more necessary now than ever, and this novel test may prove the solution.
This new spit test looks at 130 different genetic mutants to provide a polygenic risk score for the individual, and it has been shown to be a highly accurate predictor of aggressive prostate cancer, and a promising alternative to the current test. Those shown to be at high genetic risk for aggressive cancers will be referred for further diagnostic measures, while those assessed at low risk will be monitored but not put through any unnecessary procedures. It is expected that this test will catch far more cancer cases early, and save the NHS upwards of £500 million a year.
The original test was established using a database to establish risk in men of European ancestry. A further study is being conducted to assess risk variants in men of Asian and African heritage – aiming to diminish bias in the genetic database and improve the overall efficacy of the test.
Significantly more evaluation is required to establish the saliva test as a new widespread screening protocol, but this advancement is promising for men at risk across the country and conveys the benefits of genetic screening and risk prediction.
Leacsaidh Marlow
Featured image courtesy of Warren Umoh via Unsplash. Image license found here. No changes were made to this image.
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