A new means of prostate cancer screening could emerge as an alternative to the PSA test, which has long been the first-line option.
Using machine learning, a form of artificial intelligence, Swedish researchers analyzed urine samples from more than 2,000 men with prostate cancer, along with a control group.
They determined that the simple, non-invasive urine test was able to detect biomarkers of prostate cancer with a high degree of accuracy — and could also determine the grade (stage) of the disease.
The results were published in the journal Cancer Research.
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“Prostate cancer can be effectively identified by analyzing the expression of candidate biomarkers in urine,” confirmed lead author Martin Smelik from Karolinska Institutet in Stockholm, Sweden, who spoke to Fox News Digital about the findings.
“This approach outperforms the current blood tests based on PSA, but at the same time keeps the advantages of being non-invasive, painless and relatively cheap.”
The researchers were surprised by the “heterogeneity of tumors,” which refers to “the differences between tumors of the same type in different patients, the differences between cancer cells within a single tumor, or the differences between a primary (original) tumor and a secondary tumor,” according to the National Cancer Institute.
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“One of the main challenges of the study was to overcome this and to identify biomarkers that were specific for prostate cancer, but also expressed in all types of patients,” Smelik said.
Dr. Timothy Showalter, a radiation oncologist at UVA Health in Virginia and chief medical officer at Artera, was not involved in the study but commented on the findings.
“This study highlights the power of machine learning applied to patient data in identifying breakthroughs that can help us diagnose cancer earlier, when our treatments are most effective,” he told Fox News Digital.
“Prostate cancer screening has not seen a transformative advance in decades, and current approaches still rely on the PSA blood test, which is known to have low specificity for clinically significant cancers.”
What to know about the PSA
The existing PSA test works by monitoring levels of prostate-specific antigen in the blood.
It can be used to screen for prostate cancer or monitor the disease’s progression, but some risks and limitations have been noted.
“Prostate cancer screening has not seen a transformative advance in decades.”
Matthew C. Abramowitz, M.D., co-chair and clinical lead of the Genitourinary Malignancies Site Disease Group at the Sylvester Comprehensive Cancer Center in Miami, Florida, echoed the need for alternatives to the PSA test.
“While PSA is an incredibly sensitive tool for issues related to the prostate, it is not specific to prostate cancer,” Abramowitz, who was not involved in the study, told Fox News Digital.
“The techniques proposed in the current study suggest the promise of identifying specific cancer markers in the urine, minimizing some of the specificity concerns associated with PSA.”
While PSA has the advantage of simplicity, quickness and reasonable cost, determining the meaning behind any abnormal findings often requires further testing, such as MRIs and biopsies, the doctor noted.
False positives are also common with the PSA test, occurring in about 6% to 7% of the cases.
“Only about 25% of men who have a biopsy due to an elevated PSA level are found to have prostate cancer,” states the NIH.
Limitations and future research
The study did have some limitations, chiefly the low number of samples.
“The urine prostate cancer prediction model was performed on a small data set and appears to be largely an analysis of European men, both of which may limit its applicability to other high-risk prostate cancer populations,” Abramowitz noted.
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The test could also come with a significant cost increase due to the specialized equipment necessary to perform the analyses, he added.
The researchers acknowledged the need for larger studies to validate the findings and to potentially include other cancers.
“While this study was focused specifically on prostate cancer, we believe that some of the methods could be generalized to other cancers as well, which we would like to try in our future studies,” Smelik said.
The ultimate goal, according to the researchers, is to achieve more efficient screening programs within the next few years, potentially helping to prevent and treat prostate cancer.
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Showalter agreed, adding, “This work may pave the way for more specific screening methods that improve our ability to detect high-grade cancers before they progress or metastasize, ultimately improving cure rates and reducing treatment-related morbidity.”
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