Black men are at increased risk of prostate cancer, with double the risk of other men. One in four Black men will develop the disease, and those over 45 or with a family history of the disease are at greater risk.

TRANSFORM, funded by Prostate Cancer UK and the National Institute for Health and Care Research, is co-led by Professor Rhian Gabe, Professor of Biostatistics and Clinical Trials at Queen Mary University of London.

The landmark national trial aims to find the best way to screen for prostate cancer and increase the number of lives saved through screening. The trial is testing the most promising screening techniques available, including prostate specific antigen (PSA) blood tests, genetic spit tests, and fast MRI scans, combined in ways that have never been tested before in a large-scale screening trial. 

Previous trials have not included enough Black men to adequately demonstrate the harms and benefits of screening for this group, despite their significantly higher risk of developing prostate cancer. Invitations to thousands of Black men are already being sent as part of stage 1 of TRANSFORM, but this extra investment will drastically increase the number sent out as part of the second stage of TRANSFORM, starting in the next few years.

On the new funding, Professor Rhian Gabe, said: “This welcome investment addresses some of the most challenging aspects with respect to the introduction prostate cancer screening: obtaining quality evidence in a high-risk group and availability of optimal treatments for those in whom cancer is detected. Black men are at higher risk of prostate cancer and yet, have been underrepresented in the evidence informing screening policy. The investment in TRANSFORM will allow us to address this inequality, increase the scale of TRANSFORM and reliability of our evidence for all men.”

The new funding will make TRANSFORM the largest prostate cancer screening trial in 20 years and the most diverse and representative of the UK population ever undertaken.

As well as providing methodological leadership through the design and analysis of this innovative platform trial, Queen Mary are leading the behavioural science and primary care components of TRANSFORM. This work focuses on understanding how to make it as easy and relevant as possible for people to take part in the trial, particularly for those who have historically faced barriers to accessing prostate cancer testing and care.

A key part of this approach, Queen Mary has been working in close partnership with Black communities and has collaborated with community organisations, health advocates, charities and local groups, both in London and across the UK, to understand people’s experiences and priorities. This has focused on how to make testing more accessible and ensure any future screening programme is fair and responsive to community needs.

Queen Mary also facilitates the Public and Patient Involvement and Engagement (PPIE) work for the TRANSFORM trial, helping to ensure people with lived experience of prostate cancer are involved at every stage. This ensure that information and resources developed for the study reflect real experiences that are meaningful, sensitive and appropriate for the communities they are intended to serve.

The strong partnerships that the University is developing with Black communities will support the development of inclusive and informed approaches to inviting all eligible Black men to take part.