Prostate Cancer Risk Shown in New Urine Test

A recently developed urine test can assist in the early detection of and treatment decisions regarding prostate cancer, a study from the University of Michigan Comprehensive Cancer Center and the Michigan Center for Translational Pathology finds.

 

The test is designed to supplement an elevated PSA screening result. While defining those men at highest risk for clinically significant prostate cancer, the test could also delay or negate the need for a needle biopsy in some patients.

 

The test looks for a genetic anomaly of two genes changing places and fusing together, an instance that occurs in about half of all prostate cancers. This gene fusion, TMPRSS2:ERG, is believed to cause prostate cancer. However, because the genetic anomaly is present only half the time, researchers included another indicator, PCA3, in the test. In the end, the combination of both markers was more predictive of prostate cancer than either TMPRSS2:ERG or PCA3 alone.

“We think this is going to be a tool to help men with elevated PSA decide if they need a biopsy or if they can delay having a biopsy and follow their PSA and urine TMPRSS2:ERG and PCA3,” says lead author Scott Tomlins, M.D., Ph.D.

 

The researchers evaluated urine samples from 1,312 men for TMPRSS2:ERG and PCA3. They then categorized patients into low, intermediate and high scores, signifying their risk of prostate cancer. The men in the study all had elevated PSA levels and had received either a biopsy or prostatectomy. Researchers compared the TMPRSS2:ERG and PCA3 test to the biopsy results.

 

Within the low, intermediate, and high scoring groups, the rates of cancer were also lower, intermediate and higher, respectively. In the low-score group, 21% of men had cancer. Of the men in the intermediate group, 43% had cancer. And, cancer was found in 69% of men in the high-score group. Furthermore, the new urine test results also indicated the cancer’s aggressiveness, based on tumor size and Gleason score. In the low-score group, only 7% of men had an aggressive tumor, however tumors were aggressive in 40% of those in the high-score group.