Study confirms initial MRI scan best at diagnosing prostate cancer

 A London University College study has confirmed empirical evidence that

A 10-minute MRI scan could be used to screen men for prostate cancer, according to a new study. The scans proved far more accurate at diagnosing cancer than blood tests, which look for high levels of a protein called PSA. MRI picked up some serious cancers that would have been missed by PSA alone.

As long ago as March 2018, BBC Radio 4's Inside Health programme was reporting that 

just published, the largest ever study of prostate cancer over 10 years. Done in the UK, and published in the Journal of the American Medical Association, it found that doing a single screening test of PSA - confirms what we already know. It is a poor test. It found many abnormalities that wouldn’t go on to do any harm, and missed some lethal disease. And it did not delay deaths. The men in the screened group died from prostate cancer just as often as in the unscreened group.

and that an earlier trial at UCL, the PROMIS study, had shown that the traditional second stage of diagnosis, a biopsy under local anaesthetic

misses over half of all the clinically important cancers. So half the men who were told they were all clear were indeed harbouring clinically significant disease. MRI was about twice as good, it had a sensitivity so its ability to detect clinically significant disease is present in excess of 90%. And so the majority of patients that had clinically significant disease were successfully detected.

So why are health service administrators not rolling out a MRI-based screening programme? It could be that funding is the problem. MRI scanners are expensive and therefore installations are limited. There is also a shortage of trained radiologists. Referrals would therefore have to be rationed and presumably routine scans would be at the back of the queue. Private scans are available at £80 a go, but there is no guarantee that you can be scanned locally. Currently, the Swansea University Hospital is not taking bookings and the nearest alternatives are in Carmarthenshire and the Vale of Glamorgan.