Prevalence of MRI Lesions in Men Responding to a GP-led Invitation for a Prostate Health Check: a Prospective Cohort Study

Overview

Journal BMJ Oncol

Date 2025 Jan 31

PMID 39886504

Authors

Caroline M Moore

Elena Frangou

Neil McCartan

Aida Santaolalla

Douglas Kopcke

Giorgio Brembilla

Joanna Hadley

Francesco Giganti

Teresa Marsden

Mieke Van Hemelrijck

Fiona Gong

Alex Freeman

Aiman Haider

Steve Tuck

Nora Pashayan

Thomas Callender

Saran Green

Louise C Brown

Shonit Punwani

Mark Emberton

Affiliations

Soon will be listed here.

Abstract

Objective: In men with a raised prostate-specific antigen (PSA), MRI increases the detection of clinically significant cancer and reduces overdiagnosis, with fewer biopsies. MRI as a screening tool has not been assessed independently of PSA in a formal screening study. We report a systematic community-based assessment of the prevalence of prostate MRI lesions in an age-selected population.

Methods And Analysis: Men aged 50-75 were identified from participating general practice (GP) practices and randomly selected for invitation to a screening MRI and PSA. Men with a positive MRI or a raised PSA density (≥0.12 ng/mL) were recommended for standard National Health Service (NHS) prostate cancer assessment.

Results: Eight GP practices sent invitations to 2096 men. 457 men (22%) responded and 303 completed both screening tests. Older white men were most likely to respond to the invitation, with black men having 20% of the acceptance rate of white men.One in six men (48/303 men, 16%) had a positive screening MRI, and an additional 1 in 20 men (16/303, 5%) had a raised PSA density alone. After NHS assessment, 29 men (9.6%) were diagnosed with clinically significant cancer and 3 men (1%) with clinically insignificant cancer.Two in three men with a positive MRI, and more than half of men with clinically significant disease had a PSA <3 ng/mL.

Conclusions: Prostate MRI may have value in screening independently of PSA. These data will allow modelling of the use of MRI as a primary screening tool to inform larger prostate cancer screening studies.

Trial Registration Number: NCT04063566.

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