Amol Akhade: BARCODE1 study – Hype or hope in PRS-guided prostate cancer screening?
Amol Akhade, Consultant Medical Oncologist and Hemato-oncologist at Suyog Cancer Clinics, shared a post on LinkedIn about a paper by Jana McHugh et al. published in NEJM:
“BARCODE1 Study. Hype or Hope in PRS-guided Prostate Cancer Screening?
BARCODE1 used saliva DNA to identify men in the top 10% of polygenic risk for prostate cancer and invited them for MRI and biopsy.
Findings:
40% had prostate cancer 55% had clinically significant disease (Gleason ≥7) But 45% were Gleason 6 (low risk). Overdiagnosis estimated at 20.8%, higher than PSA or MRI-based screening
Biggest problem?
- No control arm — we can’t say PRS improved outcomes vs standard screening.
- Modest PRS performance (AUC 0.55–0.61)
- Limited generalizability (100% European ancestry, highly educated cohort)
Until we see randomized data showing reduced mortality and less overdiagnosis, PRS remains a promising but unproven tool and should be used with caution.”
“Assessment of a Polygenic Risk Score in Screening for Prostate Cancer”
Authors: Jana McHugh, Elizabeth Bancroft, Edward Saunders, Mark Brook, Eva McGrowder, Pardeep Kumar, Nicholas James, Nora Pashayan, Zsofia Kote-Jarai, Rosalind Eeles et al.
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