Urine Test Aids Prostate Cancer Detection

For men of a certain age, prostate cancer emerges as a greater risk. Now researchers say they have developed a simple urine test that can help detect it, perhaps leading to earlier treatment.

A new urine test can help aid early detection of and treatment decisions about prostate cancer, a study from the University of Michigan Comprehensive Cancer Center and the Michigan Center for Translational Pathology finds.

The test, developed at the University of Michigan, supplements an elevated prostate specific antigen, or PSA, screening result, and could help some men delay or avoid a needle biopsy while pointing out men at highest risk for clinically significant prostate cancer.

The test looks for a genetic anomaly that occurs in about half of all prostate cancers, an instance of two genes changing places and fusing together. This gene fusion, TMPRSS2:ERG, is believed to cause prostate cancer.

Studies in prostate tissues show that the gene fusion almost always indicates cancer. But because the gene fusion is present only half the time, the researchers also included another marker, PCA3. The combination was more predictive of cancer than either marker alone.

“Testing for TMPRSS2:ERG and PCA3 significantly improves the ability to predict whether a man has prostate cancer,” says lead author Scott Tomlins, M.D., Ph.D., a pathology resident at the U-M Health System. “We think this is going to be a tool to help men with elevated PSA decide if they need a biopsy or if they can delay having a biopsy and follow their PSA and urine TMPRSS2:ERG and PCA3.”

The researchers note that many men who have elevated PSA levels do not have cancer, but doctors normally order a biopsy just to be safe.

“The hope is that this test could be an intermediate step before getting a biopsy,” said senior study author Arul Chinnaiyan, director of the Michigan Center for Translational Pathology.