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Prostate cancer screening using MRI may reduce overdiagnosis, study finds

July 9 (UPI) -- Screening for prostate cancer using magnetic resonance imaging and targeted biopsies may reduce misdiagnoses of the disease by up to 50%, a study published Friday by the New England Journal of Medicine found.

MRI scans of the prostate would be used to spot possible tumors on the gland, which plays a role in urinary and sexual function. Men with unusual findings on their MRIs that suggest possible tumors would undergo surgery to collect sample tissue for biopsy, researchers said.

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A biopsy can determine whether the tissue is cancerous.

"Refined screening methods are required to reduce overdiagnosis and overtreatment of low-risk tumors," study co-author Martin Eklund said in a press release.

Using MRI can "prevent unnecessary biopsies and biopsy-related side effects," said Eklund, an associate professor of medical epidemiology and biostatistics at the Karolinska Institute in Stockholm.

Prostate cancer is the second most-common cancer -- after skin cancer -- in the United States, with roughly 250,000 men in the United States diagnosed annually, according to the American Cancer Society.

Screening for the disease typically entails a digital rectal exam, in which a doctor inserts a gloved, lubricated finger into the rectum to examine the prostate, which is next to the rectum.

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Doctors may also conduct a prostate-specific antigen, or PSA, test, which checks the blood for elevated levels of a substance that's naturally produced by the gland.

However, these methods may not always be accurate or may detect low-risk or non-cancerous tumors, according to Eklund and his colleagues.

As a result, many men begin treatment for prostate cancer even if they do not need it, including unnecessary biopsies and other surgeries, research suggests.

For this study, the researchers screened 12,750 men in Sweden for prostate cancer between 2018 and 2021.

All participants submitted a blood sample for PSA analysis, and those whose tests showed elevated levels were then randomly selected for traditional biopsies or MRI.

In the MRI group, biopsies were conducted strictly on suspected tumors identified through the scans.

With that approach, the number of unnecessary biopsies and the identification of minor low-risk tumors is reduced, without compromising detection of clinically significant tumors, according to the researchers.

The approach reduced by half the number of unnecessary biopsies performed on samples collected from men in the study, they said.

"Nationwide screening for breast and cervical cancer among women has been available in the Western world for some time," study co-author Tobias Nordström said in a press release.

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"We are finally able to show that men can also reduce their risk of malignant cancer through nationwide prostate-cancer screening that utilizes modern methods," said Nordström, an associate professor of urology at Karolinska.

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