Prostate Cancer Diagnosis

New Saliva Test does not supersede PSA Testing

Tackle’s Clinical Advisory Board has reviewed the new saliva test announced last week and concluded that we still need PSA testing at the moment. The full statement is:

Articles in the press and broadcast on 12 June 2018 suggested this was an exciting new test for Prostate Cancer (PCa) that could “revolutionise how men are screened” and “lead to a national screening programme on the NHS within 3 years”. Whilst the test clearly helps predict future risk of PCa, the actual conclusions drawn in the research paper itself are more realistic (Nature Genetics, accessed on line 15 June 2018).

In summary, the authors claim the test “can be used to improve the identification of men at high risk for PCa and therefore inform PSA guidelines for screening and management to reduce the burden of over-testing”. Two issues immediately arise:

  1. The above quote suggests the authors clearly see the saliva test working in tandem with PSA. This is logical as we are already able to use PSA as a useful risk predictor when used in men in their forties and fifties.
  2. The vast majority of men presenting with PCa in the UK have no known risk factors, either racial or familial. It therefore remains for future studies to demonstrate how the test can best be fitted into pragmatic, simple, cheap screening protocol, especially if it is to be used like PSA in primary care.

In conclusion, for the moment we have to remain committed to raising awareness and increasing the utility of PSA-based screening if we are to reduce the UK’s unacceptable 11,800 annual death rate from this most pernicious cancer.


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