A new saliva-based genetic test could be a game-changer in the early detection of prostate cancer, according to researchers in the UK. This innovative approach, which uses DNA analysis to identify men with a high inherited risk of developing the disease, has the potential to revolutionize the way prostate cancer is screened and treated. Scientists believe the test could identify aggressive cancers that often go unnoticed using current methods, thereby sparing lives and reducing unnecessary medical procedures. While the test is not yet ready for routine clinical use, the early results have sparked optimism among experts.
The test works by examining 130 specific genetic mutations that are known to influence the likelihood of developing prostate cancer. Unlike the commonly used prostate specific antigen (PSA) blood test, which can lead to overdiagnosis and overtreatment, the saliva test assesses a person’s genetic predisposition, offering a more targeted way of determining who might benefit most from further investigation. In a recent study, men aged 55 to 69 were asked to provide saliva samples. Those with the highest genetic risk scores approximately the top 10% were invited to undergo MRI scans and biopsies. Among the 745 men with high-risk scores, 468 agreed to further testing, which revealed 187 cases of prostate cancer, including 103 high-risk tumors. Of these, 74 would not have been detected at this stage using current standard tests.
These findings, published in the New England Journal of Medicine, suggest that the saliva test could offer a vital new tool in the ongoing fight against prostate cancer. Professor Ros Eeles of the Institute of Cancer Research in London, who co-led the study, described the results as a potential turning point. She emphasized the value in identifying men who are most likely to benefit from additional testing while avoiding unnecessary procedures for those at low risk.
One of the most compelling stories to emerge from the trial is that of Dheeresh Turnbull, a 71-year-old participant from Brighton. Despite having no family history of prostate cancer, the test revealed he was in the highest risk category. Subsequent tests confirmed that he had developed cancer. His younger brother also joined the trial and was found to have an aggressive tumor. For Dheeresh, the test quite literally saved lives in his family, demonstrating the potential of this approach on a personal level.
Despite the promising findings, experts caution that the saliva test is still far from being ready for widespread use. Professor Dusko Ilic from King’s College London noted that while the test shows potential, it has only modestly improved cancer detection when combined with existing tools. Furthermore, no direct evidence has yet shown that this test improves survival rates or overall quality of life, making further studies essential. Cost-effectiveness, the ideal timing for testing, and adapting the test for diverse ethnic backgrounds, especially Black men who are statistically at double the risk of prostate cancer, remain important challenges to address.
The test will now be integrated into the larger Transform trial, which aims to determine the best way to implement prostate cancer screening in the UK. While it may take years before the test becomes a regular part of NHS services, many in the medical community view this as a significant step toward more personalized and effective cancer detection. As Professor Michael Inouye from the University of Cambridge pointed out, this study could one day be remembered as a landmark moment in the use of genetic testing for cancer risk assessment, even though the road to clinical implementation is still a long one.
