A new study from the UK found that a mobile prostate cancer screening clinic called the “Man Van” helped address some barriers to screening by bringing education and screening directly to high-risk communities. The research will be presented at the 2025 American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium, taking place February 13-15 in San Francisco, California. 

To address health inequities in the UK, the Man Van was deployed in disadvantaged communities in Greater London with the goal of identifying men at a high risk of prostate cancer and recommending them for additional testing.

Through the clinic, men were offered a prostate-specific antigen (PSA) screening, a blood test that can identify men who are more likely to have prostate cancer. They were also offered a general health check that included a blood pressure measurement, body mass index calculation, and an HBA1c test for diabetes. The clinic targeted high-risk London communities based on the Index of Multiple Deprivation (IMD).

This is an index that ranks geographical areas based on the level of deprivation the community faces in multiple domains. These domains include income, employment, education, health, crime, housing, and environment. Many people in these communities have more barriers to accessing health care, including prostate cancer screening.

There were 3,379 men who attended a Man Van clinic between January 2023 and January 2024. The attendees were between the ages of 39 and 97, with a median age of 59 years. Over 36% of the attendees were non-White, and 16.7% were Black. The median IMD rank was within the 6th lowest decile. For the IMD, people who score a rank of 1 face the most deprivations and those with a 10 face the least.

The clinic referred 310 patients for additional testing. Of that initial referral group, 262 patients went on to have prostate MRI scans, which were given a score on the Prostate Imaging Reporting and Data Systems (PI-RAD) scale. In this group of men:

• 139 (53.1%) had a PI-RADS score of 1 or 2, which indicates a very low or low likelihood of prostate cancer.
• 35 (13.4%) had a PI-RADS score of 3, which means the risk of prostate cancer is equivocal or just as likely as not having prostate cancer.
• 85 (32.4%) had a PI-RADS score of 4 or 5, which indicates a high or very high likelihood of prostate cancer.
• 3 (1.1%) had scans that could not be scored due to technical issues.

Of those who had prostate MRI scans, 127 patients had a prostate biopsy. There were 94 patients who were diagnosed with prostate cancer and, of those, 81 had clinically significant disease that was grade 2 out of 5 or higher. None of the people who were diagnosed had metastatic prostate cancer.

After diagnosis, the participants went on to receive additional care and/or prostate cancer treatment:

• 25 (26.6%) were managed with active surveillance.
• 2 (2.1%) were treated with cryotherapy, which uses cold temperatures to freeze and remove abnormal tissue.
• 2 (2.1%) were treated with low-dose brachytherapy, a type of radiation therapy in which radioactive seeds are placed in the prostate gland.
• 39 (41.5%) had surgery to remove the prostate, called a prostatectomy.
• 26 (27.7%) had radiotherapy that was not brachytherapy.

Prostate cancer was not the only illness that was diagnosed by the Man Van. There were 59 patients who had blood in the urine (haematuria) who were seen by a specialist within two weeks thanks to an initiative in the UK to diagnose bladder cancer quickly. Of these patients, one was diagnosed with bladder cancer. There were also 43 participants (2%) who were diagnosed with diabetes and 207 participants (11%) who were diagnosed with pre-diabetes.

The Man Van resulted in a non-attendance rate of 15.1%, which was considered low. This is the percentage of people who were invited to participate but did not attend the Man Van clinic.

“Detection rates of prostate cancer are higher in more affluent men who can afford to have PSA testing privately or have better access to National Health Service care in the United Kingdom. We effectively recruited from high-risk groups of men in the UK and testing those men resulted in high rates of diagnosis of clinically significant prostate cancer, illustrating the effectiveness of a mobile facility for detecting prostate cancer in these groups,” said lead study author Masood Moghul, MBBS, Urology Fellow, Institute of Cancer Research, London. 

The researchers will continue to study the health economics of the Man Van and will study how to use sophisticated gene-based risk scores when identifying vulnerable patients.

“This research intervention to improve health equity and reduce cancer disparities shows that we can meet underserved populations where they live and improve their health and healthcare,” said Curtiland Deville, MD, Johns Hopkins University.

Watch the interview here.

Source: ASCO