A UNC Lineberger researcher has pointed to a need for more data on whether new technology designed to better detect men at higher-risk for prostate cancer will also mean improvements in survival rates and symptoms.
Ethan Basch, MD, an associate professor at the University of North Carolina at Chapel Hill School of Medicine and a UNC Lineberger Comprehensive Cancer Center member, was one of two authors on the editorial, which was published online Tuesday in The Journal of the American Medical Association. Basch is also an associate editor for the journal.
The editorial was a reaction to a study also published Tuesday in JAMA that showed that a new biopsy technique that combines magnetic resonance imaging (MRI) with ultrasound was more effective in detecting high-risk prostate cancer.
According to a news release, the study found that 30 percent more high-risk prostate cancers were diagnosed with the new technique — called targeted fusion-guided biopsy — than with standard biopsy. In addition, 17 percent fewer low-risk cancers were diagnosed with the new approach, compared to the older method. More than 1,000 men participated in the research at the National Institutes of Health (NIH) over a seven-year period.
Prostate cancer screening has come under scrutiny, with researchers asking whether benefits of early screening and intervention based on those findings outweigh potential harms — as some treatments can impact men’s sexual, bowel or urinary function. The biopsy is the second step in the prostate cancer diagnostic process after an initial blood-test called the prostate-specific antigen, or PSA test. The U.S. Preventive Services Task Force recommended against PSA screening for men of all ages 2012, and other groups have revised their screening recommendations.
In the editorial, Basch and his co-author Lawrence H. Schwartz, MD, a professor of radiology with the Columbia University College of Physicians and Surgeons, said the results of the study on the new targeted fusion biopsy technique are “compelling” and that improvement in of the accuracy of high-grade tumor detection is needed.
“This is a new approach that helps us better classify cancers as higher risk or lower risk,” Basch said. “Intuitively, it seems like a helpful test for decision making.”
But the editorial also says it isn’t yet known whether the new biopsy technique will also translate into meaningful outcomes for patients, such as benefits in symptoms, functional status or survival.
“Without conducting a randomized study or a well-conducted, large, observational study demonstrating the benefits of a new test, I feel we’re still a step away from understanding if it’s really worth it,” he said.