Could an MRI scan make prostate cancer screening more accurate?

Screening for prostate cancer with the PSA blood test can sometimes lead to unnecessary and harmful treatment, but new proposals could mitigate the issue of overdiagnosis

By Clare Wilson

4 April 2024

An MRI scan could improve the accuracy of prostate cancer screening

skynesher/Getty Images

There is both good news and bad news about prostate cancer screening. First, the bad news: the blood test involved, which measures a compound called prostate-specific antigen (PSA), is too inaccurate. As a result, some men end up having cancer treatments they didn’t really need, which can result in incontinence and erectile dysfunction.

On the other hand, combining a PSA test with an MRI scan of the prostate would make screening more accurate, especially if the dual test were recommended only for those at high risk of the tumour. A group of experts called the Lancet Commission on Prostate Cancer has made this recommendation in a new report.

A rethink on prostate screening is certainly needed, but will these new proposals succeed in reducing the harms?

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Prostate screening has long been controversial. Although PSA is released at high levels by cancerous prostate cells, it is produced at lower levels by healthy ones too.

The blood test was introduced as a way to track the success of cancer treatment. It started being used as a screening test in the 1990s, partly as a result of campaigns by men’s health groups that wanted something equivalent to breast cancer checks.