RISKMAN - Prostate Cancer Risk-based Screening Trial
Risk-based Screening for Prostate Cancer
RISKMAN was conceived by Prof Ken Muir (of the University of Manchester) and Dr Chris Parker (of the Royal Marsden Hospital) at the "Great PSA Debate" in 2009.
Put simply, RISKMAN is a trial to demonstrate that screening, using additional criteria in combination such as PSA free-to-total ratio, urinary symptoms, ethnicity and family history of the disease, will detect dangerous disease without the penalty of unnecessary biopsy, which is the main current objection to the introduction of screening.
Thanks to the generosity of many member organisations, funding was secured from 18 of our support groups and other sources to initiate trial design, ethical approval and identification of a first tranche of GP participants.
What has been achieved for this investment?
The project team, led by Prof Ken Muir have surveyed men’s and GPs’ attitudes to risk based assessment, in partnership with the Graham Fulford Charitable Trust. A pilot study using a risk-based approach has been running in primary care, with the help of Dr Jon Rees. Contacts in 6 health authority areas have been recruited to assess the practicality of data collection and risk assessment. Ideally 60 GP practices will need to run this trial over 4 years.
Work has taken place with the Karolinska (Sweden) group to establish procedures for assessing biomarkers in any collected samples. The team has also been working with a cancer centre in Poland who undertook risk assessment for some 2800 men. This showed how over 30% of men could be saved an unnecessary biopsy.
The result of these studies has been presented to the Prostate Cancer Advisory Group and the Clinical Studies Group. There is strong support for the project from many research leaders in UK and Europe.
Now that the pilot phase has been completed the project team is looking to the next phase of development
What happens next?
Funding applications for the next stage are being made to the Health Testing Authority, Movember and EU sources after PCUK found itself unable to offer further funding.
Tackle remains a strong supporter of RISKMAN but we have no plans to offer further funding, as the financing required is beyond the level that our charity can provide. Nevertheless the RISKMAN project sees Tackle as an important stakeholder in the team. Furthermore, we believe it is important to continue pursuing risk assessment as the way to progress early detection whilst avoiding over-treatment. For this reason we are also following with interest the risk assessment work currently being undertaken by PCUK.