A DNA test for prostate cancer patients could spare men unnecessary chemotherapy, according to a new study. A trial of 6,000 patients found the genetic test, known as Decipher, could indicate who would benefit from standard treatment plus a hormone drug to halt its spread.
Improving Diagnosis of Common Cancer
Scientists are trying to improve diagnosis of Britain’s most common cancer as current testing methods struggle to separate fast growing tumours from slow growing ones that could just be monitored. Diagnosing men relies on the prostate specific antigen (PSA) test which notoriously struggles to grade how aggressive tumours are.
Author Dr Sarah Howlett, of University College London’s Cancer Institute, said: "For men with very high-risk prostate cancer, preventing the cancer from spreading is critical."
Personalising Treatment
"Our findings suggest that a genomic test could help personalise treatment. Men with high-risk disease but a low Decipher score have low rates of cancer spread and could potentially be spared more intensive treatment, while men with a high score could be prioritised for it," Dr Howlett added.
The study comes after a campaign by Olympic legend Sir Chris Hoy, who has a terminal diagnosis, supported by charities and a host of politicians, called for more men to get routine prostate cancer checks. The six-time Gold medal winner sparked a national debate as to whether men with no symptoms should be offered the PSA test.
Debate Over Screening
Currently men over 50 can ask for a PSA test from their GP if concerned. If levels are raised they will receive further tests and scans. But earlier this year the UK National Screening Committee (UKNSC) recommended against screening all men using the blood test, saying the resulting overtreatment - such as surgery, chemotherapy and radiotherapy - would "cause more harm than good".
Population modelling suggested that PSA tests are not reliable enough and likely to over-treat men for too many benign tumours which would have never caused them harm. The committee concluded that while screening would reduce some prostate cancer deaths, this appeared to be balanced by it causing other men to die younger from other causes.
How the Decipher Test Works
The Decipher test uses a small part of an existing tissue biopsy from patients to analyse the genes inside cancer cells. This helps determine how aggressive the tumour is and how likely it is to spread in high risk patients who have already been diagnosed.
The new study, presented at the European Society for Medical Oncology Congress 2026 in Madrid, showed higher Decipher scores predicted worse outcomes. Linked research found that adding the hormone therapy abiraterone to standard treatment for men with high-risk prostate cancer could halve the risk of death and slow disease progression. The drug works by blocking testosterone from fuelling prostate cancer.
The Decipher score also predicted which patients whose disease had not yet spread to their lymph nodes would benefit from abiraterone to prevent further spread. Elai Davicioni, medical director of urology at diagnostics firm Veracyte, which makes the test, said: "We believe this growing evidence gives physicians a stronger reason to use Decipher before making decisions that can affect both cancer outcomes and patients' quality of life."
"These findings expand Decipher's predictive evidence to another consequential treatment decision: whether adding abiraterone will provide meaningful benefit for a man with very high-risk prostate cancer," Davicioni added.
The NHS announced in January that thousands more men with prostate cancer would be eligible for abiraterone. It was previously only available to those whose cancer had spread, but health chiefs widened this to include men whose high-risk cancer had not yet spread.
Macmillan Cancer Support analysis this summer suggested prostate cancer has become the most common cancer in the UK. It estimated there are now 600,000 Brits living with the disease, compared with around 500,000 in 2020. This has been put in part down to better awareness.
