The diagnosis of prostate cancer can involve repeat biopsies, particularly in men who have had a negative result. A genetic test developed at Wake Forest University School of Medicine could cut the need for these unpleasant and invasive repeat tests, reducing pain, anxiety and inconvenience for patients and cutting the risk of infection, as well as freeing time and budgets for healthcare providers.
In a study published online in the Journal of European Urology, the researchers looked at biopsies and genetic profiles of 1,654 men in the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) clinical trial. All had initial negative biopsies and then further biopsies at two and four years. The researchers found that combining a genetic score based on changes in one letter in the genetic code (single nucleotide polymorphism) with current clinical diagnostic techniques improved prostate cancer prediction.
"The genetic test outperformed the PSA test in assessing cancer risk," said Karim Kader, co-investigator and urologic surgeon at UC San Diego Health System. "If results of this blood test were factored into prostate cancer predictors such as total free PSA, free PSA, number of core samples taken at biopsy, and family history, we would have a more accurate picture of whether or not a man is likely to develop the sometimes fatal disease."
More than 1 million men in the U.S. will have prostate biopsies in the course of disease diagnosis, and around 30% of these will have more than one biopsy. As the genetic score could be checked at any time in a man's lifetime, this could be used for pre-screening, cutting the need for biopsies particularly for those with intermediate clinical risk of prostate cancer.