Diagnostic urine test identifies ‘intermediate risk’ prostate cancer patients

December 2021 Clinical Practice Nalinee Pandey
Blue ribbon symbolic of prostate cancer awareness campaign and men's health in November month on Jeans denim

A new urine based diagnostic test has been designed by the researchers at University of East Anglia for prostate cancer patients. This test can detect patients who are at ‘intermediate risk’ allowing them to benefit from active surveillance and avoid immediate treatment.

Prostate cancer is one of the most common cancer affecting men worldwide. Importantly, these cancers develop slowly, and majority of the affected individuals may not require any treatment during their lifetime. The most commonly used diagnostic tests for prostate cancers include blood tests, digital rectal examination (DRE), MRI scan and invasive biopsy. Despite these diagnostic test and checks, it is very difficult for the clinicians to predict whether the tumor will progress to an aggressive form or not, which consequently makes it hard to decide the course of treatment. To address these diagnostic issues, the team had previously developed a urine-based test called as Prostate Urine Risk (PUR) test, which can identify men with low and high-risk prostate cancers. Recently, the researchers have fine tuned the test which can successfully diagnose patients with intermediate risk- for whom the therapeutic options have been relatively less clear.

The Lead researcher Dr Jeremy Clark of the study said: “While prostate cancer is responsible for a large proportion of all male cancer deaths, it is more commonly a disease men die with, rather than from. Therefore, there is a desperate need for improvements in diagnosing and predicting outcomes for prostate cancer patients to minimize over-diagnosis and over-treatment while appropriately treating men with aggressive disease, especially if this can be done without taking an invasive biopsy.’

It is known that disease progression in intermediate-risk men is associated with the presence of increasing amounts of Gleason pattern 4 cancer in their prostate. This study shows that the PUR test can assess the amount of Gleason pattern 4 without the need for a biopsy. The researchers aim to validate their findings in a much larger cohort of men using samples collected from patients by post.


Ball RY, Cardenas R, Winterbone MS, Hanna MY, Parker C, Hurst R, et al. The Urine Biomarker PUR-4 Is Positively Associated with the Amount of Gleason 4 in Human Prostate Cancers. Life 2021;11:1172.