Prostate Cancer Detection: A Systematic Review of Urinary Biosensors - Beyond the Abstract

Prostate cancer is among the most common cancers in men, and a common cause of cancer related death. Definitive detection is through a needle biopsy with MRI imaging. There is currently no widely adopted routine screening test for prostate cancer. Prostate-specific antigen (PSA) blood testing and digital rectal examination (DRE) are commonly undertaken to initiate an investigation. PSA testing has been available for a number of decades, but it is controversial because of its high rates of false positives and false negatives.1 A screening program using these methods would result in overdiagnosis and lead to overtreatment with high rates of complications, risks, and costs.2 A non-invasive diagnostic method with high accuracy to detect aggressive cancers is needed. A number of strategies have been deployed in attempts to improve prostate cancer screening tests.


Our recent paper reviewed studies that report the use of urine-based biosensors to detect prostate cancer in patients. We identified 76 such articles and discussed 14 in the review which studied urine samples from prostate cancer patients. These studies detect prostate cancer through sensing biochemical, protein, or nucleic acid levels in urine samples. The studies reported several promising approaches but typically had small sample sizes and were poorly designed to assess the utility of such tests in a population setting. Each class of detection has unique strengths which may be useful in addressing this clinical problem. The tests also have weaknesses that must be assessed in the context of the well-established tests which are already available. Furthermore, whether such devices can discriminate between aggressive and indolent cancer has not yet been addressed and will entail optimized multiplexed biomarker panels and long-term clinical trials.

Written by: Kit Man Chan, Jonathan M Gleadle, Michael O'Callaghan, Krasimir Vasilev, Melanie MacGregor

UniSA STEM, University of South Australia, Adelaide, SA, 5095, Australia., Department of Renal Medicine, Flinders Medical Centre, Flinders University, Bedford Park, SA, 5042, Australia., Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA, 5042, Australia., Future Industries Institute, UniSA STEM, University of South Australia, Adelaide, SA, 5095, Australia., Future Industries Institute, UniSA STEM, University of South Australia, Adelaide, SA, 5095, Australia.

References:

  1. Mottet, N.; van den Bergh, R. C. N.; Briers, E.; Van den Broeck, T.; Cumberbatch, M. G.; et al., EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer—2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur. Urol. 2021, 79 (2), 243-262.
  2. Gustavsen, G.; Gullet, L.; Cole, D.; Lewine, N.; Bishoff, J. T., Economic burden of illness associated with localized prostate cancer in the United States. Future Oncol. 2020, 16 (1), 4265-4277.

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