Report by Rhys Blakely, Science Correspondent of The Times Health. Saturday December 10 2022,

More than 52,000 men are diagnosed with prostate cancer each year. Researchers have developed the first system that can predict a man’s future risk of prostate cancer based on his family history and his genetics. The tool, developed by the University of Cambridge and the Institute of Cancer Research in London, looks at hundreds of gene variants linked to the disease.

This is combined with information on the man’s family history of cancer to provide a personalised risk score. This indicates the likelihood of them developing prostate cancer over the next decade and could be used to help decide whether further testing is needed.
Prostate cancer is the most common type of cancer in men. According to Cancer Research UK, over 52,000 are diagnosed with the disease each year and there are more than 12,000 deaths.

Nearly 80 per cent of men diagnosed with prostate cancer survive for more than ten years, but this proportion has barely changed over the past decade. At present, testing involves a blood test that looks for a protein known as a prostate-specific antigen (PSA) that is made only by the prostate gland. However, it is not always accurate. According to the NHS website, around three in four men with a raised PSA level will not have cancer.

Professor Antonis Antoniou of the University of Cambridge said: “What we need is a way of identifying those men who are at greatest risk, allowing us to target screening and diagnostic tests where they are most needed, while also reducing the harms for those men who have low risk of the disease. This is what CanRisk-Prostate [the new system] aims to do.”

A study, published in the Journal of Clinical Oncology, showed promising results, but more research will be needed before it could be rolled out by the NHS. “The ultimate test is, does it lead to improved survival? To answer this, you need a large-scale trial,” Antoniou said. Discussions are under way with a view to holding one.

To gauge how well the system performs, the researchers used it to assess around 170,000 healthy men participating in the UK Biobank project.
It gave each man a risk score, predicting the likelihood of prostate cancer in the following ten years. During that time, 7,624 developed prostate cancer.

The 170,000 men were divided into two groups, according to their predicted risk — one half with highest predicted scores and one half with lowest predicted scores. About 86 per cent of the men who developed prostate cancer during the ten-year period were in the half with the highest risk scores.