Thousands of men will receive a letterbox-friendly home test kit to check for prostate cancer, which could help catch the disease years before other screening methods.
The simple urine test – dubbed the ‘Prostate Screening Box’ – is intended to diagnose aggressive prostate cancer without men having to leave their homes.
Currently, it’s hard to tell which types of prostate cancer can be left alone and which require urgent action. “It is not a simple matter to predict which tumours will become aggressive, making it hard to decide on treatment for many men,” says lead researcher Dr Jeremy Clark, from UEA’s Norwich Medical School.
But in a small pilot study, the new tests predicted which patients required treatment up to five years earlier than standard clinical methods.
Such tests are considered revolutionary because they could also mean men wouldn’t need to go to clinics for blood tests or rectal examinations in the future – and could instead be screened from the comfort of their own homes.
How do the tests work?
The tests will be sent out as part of a trial run by the University of East Anglia and the Norfolk and Norwich University Hospital (NNUH).
Men taking part in the trial will receive a home urine-sampling kit and will be asked to provide two urine samples – they’ll be asked to urinate into a test tube (via a funnel) first thing in the morning and then take another urine sample an hour later. The kit features funnels to help direct the flow of urination, two test tubes and their respective lids, and a timer.
The samples are then sent back to a lab for analysis. The test specifically looks at gene expression in urine samples and provides information about whether a cancer present is aggressive or ‘low risk’. Collected samples will be used to analyse the health of the prostate in 2,000 men in the UK, Europe and Canada.
“The Prostate Screening Box part sounds like quite a small innovation, but it means that in future the monitoring of cancer in men could be so much less stressful for them and reduce the number of expensive trips to the hospital,” says Dr Clark.
Why urine?
The prostate is a small gland in the pelvis found only in men. About the size of a walnut, it’s located between the penis and the bladder. It constantly produces secretions that naturally flow into the urethra – the tube through which urine passes from the bladder.
These secretions carry cells and molecules from all over the prostate which are flushed out of the body on urination. The test collects these and examines them. As Dr Clark explains: “It’s a way of sampling the whole prostate in one go.”
As the prostate is constantly secreting, the levels of biomarkers in the urethra will build up with time. Collecting from the first wee of the day means that overnight secretions can be collected which makes the analysis even more sensitive.
What does the trial hope to achieve?
The team has already trialled the kit in a small group of participants and are now rolling it out to thousands more men as part of the next phase in testing. Men can’t sign up for this particular phase of the trial as the charity Movember, which helped fund the research, has already identified those suitable to take part.
Samples will be collected from: men that have had a PSA test (a type of blood test used to screen for prostate cancer) and the result flags them up as possibly having prostate cancer; men with ‘low risk’ prostate cancer; and men with a genetic predisposition to having prostate cancer. These individuals will mostly be aged between 55 and 80 years old.
Unsurprisingly, feedback so far has been positive. Participants from the early stage trials preferred the at-home test compared to having to go to hospital.
“We hope that using our Prostate Screening Box could in future revolutionise how those on ‘active surveillance’ are monitored for disease progression, with men only having to visit the clinic after a positive urine result,” says Dr Clark. “This is in contrast to the current situation where men are recalled to the clinic every six to 12 months for a range of tests.”
A negative urine test could enable men to only be retested every two to three years, relieving stress to the patient and reducing hospital workload, he adds.
Robert Mills, consultant clinical director in urology at NNUH, says the test has the potential to “significantly change” how prostate cancer is diagnosed and managed. If trials go well, the test could be landing on a doormat near you in three years’ time.