TRANSFORM study extends prostate cancer screening to Black men in the UK

Today the Secretary of State for Health and Social Care, James Murray MP, has announced that all eligible Black men in the UK aged 45 to 74 will be invited for prostate cancer screening as part of the landmark TRANSFORM study led by researchers at Imperial College London and Imperial College Healthcare NHS Trust.

Black men are known to be 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.

The TRANSFORM screening trial, funded by charity Prostate Cancer UK and the UK government’s National Institute for Health and Care Research (NIHR) and led by Imperial College London and partners, is a landmark national study which aims to find the best way to screen for prostate cancer and increase the number of lives saved.

The latest news follows recent final recommendations from the National Screening Committee which advised that only men with a genetic risk factor (BRCA2) and a family history of certain cancers would be eligible for screening.

By extending TRANSFORM to include all eligible Black men, it means thousands more men in the UK could benefit from earlier detection and treatment for prostate cancer, helping to progress research into the disease.

One of the most important screening trials in decades

Professor Hashim Ahmed, Chair of Urology at Imperial College London, consultant urological surgeon at Imperial College Healthcare NHS Trust, and Chief Investigator of TRANSFORM, said: “Today’s announcement is great news and very welcome. The TRANSFORM study is one of the most important screening trials in decades and could prove a game changer for prostate cancer research as a whole.

“The extension of the study, which would see tens of thousands of Black men being invited for prostate cancer screening, is a huge step forwards and we hope it will help to fill the current gaps in evidence and inform future decisions on national screening.

“We know that Black men have high rates of prostate cancer and may be at twice the risk of developing the disease compared to other men. However, the National Screening Committee review showed that the evidence in this important group of men is lacking and more data is needed for them to make a decision about targeted screening in the Black community. It is vital that guidelines and policy recommendations reflect the evidence and I am glad that we in the TRANSFORM team can help address shortcomings of the current evidence.

“With the backing of Prostate Cancer UK and the UK government, and working with our clinical partners and patient advocacy groups, we hope this pivotal work will enable more men to survive the disease and retain their quality of life.”

Laura Kerby, Chief Executive at Prostate Cancer UK, said: “This announcement is a truly historic moment, bringing us a step closer to a world where no man dies from prostate cancer.

“Black men are twice as likely to get the disease, and twice as likely to die from it. That’s why we’re delighted that the Government has more than doubled its support for TRANSFORM, allowing us to reach tens of thousands more Black men and generate the vital evidence we need to ensure those at highest risk are diagnosed earlier, when treatment is most effective.

“It also strengthens our Black Health Equity Strategy, helping us reach more Black men with clear, trusted information and make it easier to take part in research like this that will revolutionise how we diagnose and treat the disease.

“This progress has only been possible because of the commitment, trust and leadership of Black communities across the country, and together, we are now driving change that will save lives for generations to come.”

Currently, 1 in 8 men will get prostate cancer in their lifetime. Men over the age of 50, who are Black, who have a BRCA genetic mutation, or have a family history of the disease, are all at increased risk.

About TRANSFORM

TRANSFORM is a landmark trial led by researchers at Imperial College London and Imperial College Healthcare NHS Trust, alongside co-investigators at UCL, Queen Mary University of London and the Institute of Cancer Research. The trial aims to find a way to make diagnosis earlier, safer, and more effective.

Up to 300,000 men will be recruited to the trial, which will work out the best way to diagnose prostate cancer. It will test the most promising screening techniques available, including 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.

The first invitations were sent out to men at the end of last year – with men receiving letters from their GP practice inviting them to participate.

Previous trials have not included enough Black men to adequately demonstrate the harms and benefits of screening for these men – despite their significantly higher risk.

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.

The first stage of the trial will continue to recruit as planned and will ensure that 10% of men invited are Black men. Results from that first stage should be available before the end of 2027 and will allow researchers to decide exactly which combination of tests will be taken forward into stage two, and exactly how many men will be needed to take part in that second stage. Thanks to this additional investment, all Black men who would be eligible for screening will then be invited over the following six years for at least two screening appointments.

The Government, through NIHR, has already backed TRANSFORM with £16m of co-funding. This additional investment of up to £18m means that all Black men aged 45-74 who have not had a recent PSA blood test will be given the opportunity to participate in the landmark trial.

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