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January 2018

Risk score could inform PSA screening decisions  

A new score for predicting a man’s genetic risk of developing aggressive prostate cancer could help guide decisions about who to screen and when, say researchers in The BMJ .

Prostate cancer is the most frequently diagnosed cancer in men, with over a million new cases and over 300,000 associated deaths estimated worldwide in 2012.Screening for prostate specific antigen (PSA) can lead to early detection and potentially life saving treatment.

But universal screening is not recommended because of concerns about elevated PSA in men without cancer and overtreatment for men who have cancer but might never develop aggressive disease.Ideally, physicians would identify and screen patients at high risk of developing aggressive prostate cancer at a young age, but a practical clinically useful tool to predict age of onset is not yet available.

So researchers used data from an international study collaboration (the PRACTICAL consortium) to develop and test a genetic tool to predict age of onset of aggressive prostate cancer and to guide decisions of who to screen and at what age. They analysed over 200,000 gene variants and identified 54 associated with increased risk of prostate cancer, and developed a hazard score.

Men in the top 2% of the score had an almost three-fold greater relative risk for aggressive prostate cancer compared with men with average risk. The score represents a man’s fixed genetic risk, so it can be calculated once, long before onset of prostate cancer, and be used to decide whether or not the individual should be screened.

The researchers say the score ‘is a relatively inexpensive assessment of an individual man’s age-specific risk and provides objective information on whether a given patient might benefit from PSA screening.’ Seibert T, et al.

BMJ 2018;360:j5757


A charity has launched a new free app to encourage men to perform regular checks of their testicles to improve early identification of worrying changes, and to encourage them to seek early professional help.[/bold]

With over 16,000 new cases of testicular cancer diagnosed in the UK each year, early detection means 95% of males will make a complete recovery.  

The app, from The Odd Balls Foundation, is being backed by international sportsmen, sports teams and premier league football clubs. It features a short video on how men should check themselves, and once a month, a reminder will flash up on the user’s phone to prompt them to ‘check yourself now’.

Former Premier League footballer and patron of the charity, Stephen Harper, said: ‘Unless we get a reminder, most of us just don’t think about it.  Most of us have our phones in our hands, so there is no excuse not to download the app.  It’s very simple, with a monthly reminder so you can’t forget.  This could save your life.’

The app is available at usual outlets.