Researchers have developed a test based on a urine sample. This technique could make it possible to avoid certain biopsies.
- Screening for prostate cancer can be done with a simple urine test
- It is the level of spermine in the urine which is a marker of the disease
- This technique is reliable, less invasive and would avoid “unnecessary” biopsies
How to screen for prostate cancer while avoiding biopsies”useless“? Researchers from Hong Kong Baptist University and the city’s Chinese University School of Medicine (CU Medicine) have found the solution: a urine test that can detect spermine levels. This compound is naturally present in sperm, it notably gives it its odor. Combined with other clinical indicators, the test called “spermine risk level“, is an alternative screening technique, and reliable according to the researchers who created it. They explain how it works in Prostate Cancer and Prostatic Diseases.
How to detect prostate cancer?
Screening for prostate cancer is currently based on two tools: digital rectal examination and the PSA assay, for prostate-specific antigen. For the first, its reliability depends heavily “the skills and experience of the doctor“, underline the researchers. The second screening method consists of measuring the level of PSA in the blood. This protein is produced by the prostate, and normally present in small quantities in the blood. When its level is greater than 4 ng/mL, it is considered suspicious and should be reassessed. Above 10 ng/mL, doctors consider it “pathological“, a biopsy must be performed to confirm the diagnosis of cancer. According to the researchers, three out of four men discover after this examination that they do not have prostate cancer. “Patients are at risk of complications due to the invasive nature of the biopsy“, they point out.
A non-invasive method
To develop this new screening method, they recruited 905 patients between 2015 and 2019: all had a scheduled biopsy, following an abnormal digital rectal examination or a high PSA level. Urine tests were done before they did the biopsy. Hong Kong scientists had previously found that people with prostate cancer generally have lower than average levels of spermine in their urine. In this study, they noticed that of the men with the lowest amount of spermine in their urine, half had prostate cancer. This data was combined with other information, such as DRE results, PSA levels and prostate volume to develop the “spermine risk level“. The higher this level, the greater the risk of prostate cancer. When it exceeds 6.2, researchers recommend that patients have a biopsy to confirm the diagnosis. This trial shows that 37% of patients would have been able to avoid an unnecessary biopsy with this new method. For Dr. Peter Chiu Ka-fung, author of the research, this study is a “novel and promising approach to interrogating the limitations of currently used diagnostic techniques“. Prostate cancer is the most common in France, whether in the general population or in men in particular: 54,000 new cases are diagnosed each year.
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