A new urine-based test has identified prostate cancer with 91 per cent accuracy in studies, raising hopes it could reduce the need for invasive biopsies.
The test looks for three biomarkers – TTC3, H4C5 and EPCAM – proteins in urine linked to prostate cancer.
In validation studies, it detected cancer 91 per cent of the time and ruled out healthy individuals with 84 per cent accuracy.
Senior study author Ranjan Perera is director of the Center for RNA Biology at Johns Hopkins All Children’s Hospital and professor of oncology and neurosurgery at Johns Hopkins University School of Medicine.
Perera said: “This new biomarker panel offers a promising, sensitive and specific, noninvasive diagnostic test for prostate cancer.
“It has the potential to accurately detect prostate cancer, reduce unnecessary biopsies, improve diagnostic accuracy in PSA-negative patients, and serve as the foundation for both laboratory-developed and in vitro diagnostic assays.”
Researchers analysed urine samples in two phases: 341 specimens in development and 1,055 in validation, a total of 1,396.
The biomarkers were present in patients before prostate-removal surgery but almost absent afterwards, confirming their prostate origin.
The test achieved an area under the curve (AUC) of 0.92, where 1.0 represents perfect performance.
It maintained accuracy in 78.6 per cent of cases in the development study and 85.7 per cent in validation where PSA (prostate-specific antigen) blood tests were negative, and distinguished cancer from benign conditions with an AUC of 0.89.
PSA blood tests, the current standard, measure a protein produced by both cancerous and non-cancerous prostate tissue.
Levels above 4.0 nanograms per millilitre usually trigger a recommendation for biopsy – a procedure where small tissue samples are taken with needles.
The panel picked up cancer even when PSA levels were normal and distinguished prostate cancer from conditions such as prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (enlarged prostate).
Vipul Patel is director of urologic oncology at AdventHealth Cancer Institute in Florida.
Patel said: “This test has the potential to help physicians improve diagnostic accuracy of prostate cancer, reducing unnecessary interventions while allowing early treatment for those who need it.
“On behalf of physicians and patients globally, I advocate for further study and progress for these biomarkers.”
