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Study recommends men with high risk of prostate cancer should regularly do this

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By Mark Waghorn via SWNS

Men born at high risk of developing prostate cancer should be given genetic checkups by their GP, according to new research.

It could lead to earlier diagnosis and treatment - dramatically improving survival rates, say scientists.

Currently, men suspected of having the disease have a blood test that detects raised levels of the prostate-specific antigen (PSA).

But genetic markers that predict risk could be incorporated into GP prioritization and referral processes.

Lead author Dr. Harry Green, of the University of Exeter, said: “Our study is the first to demonstrate incorporating genetic risk into GP’s risk assessment of patients' symptoms of possible prostate cancer could result in faster referral for those at most risk."

The findings are based on 6,390 men from the UK Biobank, whose records showed they had seen a GP with potential prostate cancer symptoms.

Genetic risk was calculated using more than 250 known mutations linked to the disease. These variants are combined into a single score.

Lead investigator Dr. Sarah Bailey, also from Exeter, said: "This is potentially an exciting new strategy for early cancer detection.

"Not only can high-risk patients be fast-tracked, but those at low risk can safely avoid invasive investigations.

"Using this technique would align well to the NHS Long Term Plan, which pledges to become the first national health care system to offer whole genome sequencing as part of routine care.

"This could be a clear example of improving early diagnosis, and therefore treatment and survival."

The study found it could improve referrals for those in need and, importantly, avoid invasive biopsy investigations for those at low risk.

Assessing genetic risk in primary care offers hope of earlier diagnosis for the most vulnerable men - when treatments are most effective.

Prostate cancer accounts for around a quarter of new cancer cases in men. About 52,000 patients are diagnosed in the UK each year.

It is the second most common cause of cancer death in men. Five-year survival doubles if it is diagnosed at an early rather than advanced stage.

Symptoms are common and easily misdiagnosed. An estimated 14 percent of prostate cancer deaths could be avoided if they were diagnosed earlier.

blue silk ribbon attached to a white coat of a medic. Prostate cancer awareness. World cancer day concept
(MorphoBio via Shutterstock)

GPs make around 800,000 suspected prostate cancer referrals annually in the UK. The disease claims around 12,000 lives a year.

The researchers estimate their technique will speed up investigations for 160,000 men while 320,000 others would safely avoid unnecessary procedures.

At the moment, a PSA test is used to examine men with erectile dysfunction or urination problems. Accuracy is unclear, and false positive results are common.

Only one in three men with a positive PSA test has cancer. An invasive and unpleasant biopsy is often needed for diagnosis. Research shows the PSA test can miss around 15 percent of cancers.

Kirsten Higgins, whose family are long-term supporters of the University of Exeter, funded the study.

She said: "We are delighted to be able to support the Exeter team to explore the application of genomics data in a more targeted approach to prostate cancer detection.

"It is very exciting to see the real world benefit to patients of this innovative new approach."

Richard Westlake endured 18 months of anxiety before he was declared clear of prostate cancer.

Now 74, Mr. Westlake, a retired Devon County Councillor and railway train driver, was first alerted in November 2015 that his night-time trips to the toilet may be a sign of the condition, combined with a raised PSA test.

He faced months of hospital visits, first for a biopsy, then for a more invasive biopsy, along with x-rays and a combination of other tests, each followed by an anguished wait for the result. Finally, after a second biopsy in June 2017, he was given the all-clear.

Mr. Westlake, from Exeter, said: "I was quite surprised to be honest. I had been expecting it to be positive, all that time.

"But I wasn't celebrating - I had been through a very difficult time, with all that testing, waiting, unpleasantness and anxiety. I knew it had to be done, and all the staff I met were brilliant, but it was a horrible, drawn-out experience.

"Prostate cancer is one of the most common cancers in men, and you think of all the hours of NHS time and resource going into this testing.

"If this new way of assessing patients could cut down on the number of men who have to experience that, I think it would have huge benefits, both to patients and to the NHS."

The study is in the British Journal of Cancer.

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