A new saliva test could significantly improve the early detection of prostate cancer, according to recent scientific research. The test, designed to assess a man’s inherited risk of developing the disease, may help identify aggressive cancers at an earlier, more treatable stage potentially transforming the way prostate cancer is diagnosed.
Unlike traditional methods that rely on prostate-specific antigen (PSA) levels in the blood, the saliva test analyses a person’s DNA for 130 genetic mutations associated with a higher risk of prostate cancer. This at-home test could spare many men from unnecessary treatments while targeting those most at risk for further investigation through MRI scans and biopsies.
In a recent study, men aged between 55 and 69 were tested and ranked according to their genetic risk scores. Those in the top 10% were invited for follow-up assessments. Of the 745 men with high-risk scores, 468 agreed to additional tests. Among them, 187 were found to have prostate cancer, and 103 had high-risk tumours requiring treatment. Notably, 74 of these would likely have gone undetected using current PSA-based screening.
The implications are promising, with the potential for earlier diagnosis and better outcomes. Detecting aggressive cancers at an earlier stage is crucial, as prostate cancer remains one of the leading causes of cancer-related deaths in men. In the UK, approximately 12,000 men die from the disease annually.
The limitations of PSA tests have long been a concern. While PSA testing can be helpful, it also carries the risk of over-diagnosis and over-treatment, especially in cases where the cancer would not have posed a serious threat. This has been a major barrier to implementing widespread screening programmes for prostate cancer. The new genetic saliva test may offer a more precise alternative, helping doctors better determine who truly needs further testing and treatment.
One of the men who participated in the trial discovered he was at high risk despite having no family history of prostate cancer. Following further scans, he was diagnosed with the disease. Remarkably, his younger brother, who also joined the study, was found to have an aggressive tumour. These findings highlight how genetic testing can reveal hidden risks and potentially save lives that might otherwise be lost due to late diagnosis.
Despite the encouraging results, experts caution that the saliva test is not ready for widespread clinical use. While the test demonstrated improved detection rates when combined with current risk assessments like age and MRI results, it has not yet been shown to improve survival outcomes or overall quality of life. Further research is necessary to validate its effectiveness and determine whether it can be implemented cost-effectively across diverse populations.
Currently, the test has only been trialled on individuals of European ancestry. Researchers are working to adapt the test for other ethnic groups, particularly Black men, who statistically face a significantly higher risk of developing prostate cancer.
The saliva test is now being incorporated into the larger Transform trial, which aims to identify the most effective strategy for prostate cancer screening in the UK. While it may take several years before such testing becomes part of routine care, many believe the study marks a major milestone in integrating genetic data into cancer risk assessment. It could lead to a more personalised and efficient approach to prostate cancer screening in the future.
