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Using MRI scans to screen men for prostate cancer could reduce deaths from the disease “significantly”, researchers have suggested. Scientists said current tests, which detect the level of the protein prostate-specific antigen (PSA) in the blood, have been linked to over-diagnosis and over-treatment of low-risk cancer. Prostate cancer is the most common cancer found in men and, at the moment, those aged over 50 can request a PSA test if they are experiencing symptoms. The Reimagine study invited 303 men aged between 50 and 75 to have a screening MRI and a PSA test. Of the total, 48 (16 per cent) had an MRI that indicated the presence of prostate cancer despite having a median PSA density. Of the group, 32 had lower PSA levels than the current screening benchmark of 3ng/ml, meaning they would not have been referred for further investigation. After NHS assessment, 29 men were diagnosed with cancer that required treatment, 15 of whom had serious cancer and a PSA of less than 3ng/ml. Three men (1 per cent) were diagnosed with low-risk cancer that did not require treatment. Our results give an early indication that MRI could offer a more reliable method of detecting potentially serious cancers early Prof Caroline Moore The study was led by University College London, University College London Hospitals NHS Foundation Trust and King’s College London and is published in medical journal BMJ Oncology. Prof Caroline Moore, consultant surgeon at UCLH, chief investigator of the study and NIHR research professor, said the findings are “sobering” and “reiterates the need to consider a new approach to prostate cancer screening”. “Our results give an early indication that MRI could offer a more reliable method of detecting potentially serious cancers early, with the added benefit that less than 1 per cent of participants were ‘over-diagnosed’ with low-risk disease,” she added. Prof Mark Emberton, consultant urologist at UCLH, said: “The UK prostate cancer mortality rate is twice as high as in countries like the US or Spain because our levels of testing are much lower than other countries. “Given how treatable prostate cancer is when caught early, I’m confident that a national screening programme will reduce the UK’s prostate cancer mortality rate significantly. There is a lot of work to be done to get us to that point, but I believe this will be possible within the next five to ten years.” Nick James, a professor of prostate and bladder cancer research at the Institute of Cancer Research in London said the study “further reinforces the value of MRI in the diagnostic pathway for prostate cancer”. “The well-known limitations of the old PSA-based screening studies of over- diagnosis and linked over-treatment are increasingly mitigated by the use of MRI,” he added. “Similarly, MRI can also spot cases of prostate cancer in patients with normal PSA levels, who would have been missed using PSA only screening programmes.” MRI scans have revolutionised the way we diagnose prostate cancer, and it’s great to see research into how we might use these scans even more effectively Simon Grieveson, Prostate Cancer UK Prof Sir Mike Richards, chairman of the UK National Screening Committee (NSC), said the organisation does not currently recommend prostate cancer screening “because there is no clear evidence that the benefits outweigh the harms”. However, it is preparing to look at various proposals. He added: “The UK NSC will soon commission a major piece of work to consider six prostate cancer screening proposals that were submitted during its annual call for topics. “These include targeted and risk-stratified screening proposals for screening groups of men at higher risk due to factors such as ethnicity and family history.” Simon Grieveson, assistant director of research at Prostate Cancer UK, said: “MRI scans have revolutionised the way we diagnose prostate cancer, and it’s great to see research into how we might use these scans even more effectively. “These results are extremely exciting, and we now want to see much larger, UK-wide studies to understand if using MRI as the first step in getting tested could form the basis of a national screening programme.” Another trial, known as Limit, is being conducted with a much larger number of patients, which the research team said is the “next step towards a national prostate screening programme”. The trial will also attempt to recruit more black men, after the team behind Reimagine found they were much less likely to respond to the invitation to screening than others. Saran Green of King’s College London said: “One in four black men will get prostate cancer during their lifetime, which is double the number of men from other ethnicities. “Given this elevated risk, and the fact that black men were five times less likely to sign up for the Reimagine trial than white men, it will be crucial that any national screening programme includes strategies to reach black men and encourage more of them to come forward for testing.”

The destruction of the Nova Khakhovka dam will likely turn Ukraine’s southern fields “into deserts” within the year – sparking a global food security crisis, top Ukrainian officials have warned. Ukraine’s emerency services are carrying out rescue operations across dozens towns and villages in the wake of the dam – which is under Russian occupation – unleashing the waters of one of Europe’s largest reservoirs across the war-torn south. The deluge has destroyed homes, drowned animals, severed clean water supplies and forced thousands of people to evacuate. The sudden emptying of the reservoir has crippled key irrigation systems in three surrounding regions. That has stopped the water supply to nearly 600,000 hectares of agricultural land, and endangered the production of 4 million tonnes of grain and oil crops, Ukraine's agricultural ministry wrote in a statement. “The fields in the south of Ukraine may turn into deserts as early as next year,” the ministry said, adding that the surrounding countryside and water supplies have also been destroyed and fish stock killed. “In total, according to preliminary calculations, the losses from the death of all biological resources will amount to [$285 million dollars],” it concluded. Mykhailo Podolyak, a chief advisor to President Zelenksy, warned this “global ecological disaster” could impact worldwide food supplies, as Ukraine, nicknamed the bread basket of the world, is a major producer of grains and oils. “The instantaneous death of a large number of fish and animals, the waterlogging of drained lands and the change in the climatic regime of the region will later be reflected in the food security of the world,” he told The Independent. Ukraine holds the western bank of the Dnipro River near the dam - where some 16,000 people were affected by the flood. Russia controls the eastern side, which is lower and more vulnerable to flooding and where some 22,000 people are impacted. About 3,000 people have already been evacuated from flooded areas on both sides of the river, officials said. The Ukrainian military has blamed Moscow for the attack, saying Russia wants to prevent an advance by Ukrainian forces. The Kremlin denies the accusations saying Kyiv is seeking to distract from a “failing” counteroffensive, that is ongoing. The Kakhovka hydroelectric dam and reservoir are essential for drinking water and irrigation for a huge area of southern Ukraine and the Crimean Peninsula, which has been occupied by Russia since 2014. It lies in a part of the Kherson region that has been controlled by Moscow's forces for the past year since President Vladimir Putin launched his invasion. On Wednesday the authorities and charities rushed to get drinking water and food supplies to the flooded areas and to help save those who are stranded. In the city, people used boats and rafts to try to find missing inhabitants, while others waded through knee-deep water clutching their belongings. “There were people standing on the street just in their underwear because the water had come in too fast and submerged their homes and belongings,” said Yuliya Konovalova, an aid worker who works for Ukrainian animal charity Hachiko. She had spent the day bringing hot meals and water to the inhabitants of Kherson, and rescuing and feeding stranded pets. "The water was rising so fast we hope those people manage to escape,” she added. She said in the centre of the city trains were leaving every two hours despite the flooding and the shelling to ferry people to the nearby city of Mykolaiv “It is a disaster, it is a catastrophe, it is difficult to understand how it is possible.” “It was a really painful day, on the way back I was crying,” she added breaking down in tears. Ukrainian President Volodymyr Zelensky said that Russian soldiers were shooting from a distance while rescue attempts were in progress. "As soon as our helpers try to save them, they are shot at," he told German newspapers Bild and Die Welt and also Politico. The country’s deputy prime minister, Oleksandr Kubrakov, also warned of drifting landmines unearthed by the flooding. "Water is disturbing mines that were laid earlier, causing them to explode," Mr Kubrakov said. “As a result of the flooding, infectious diseases and chemicals were getting into the water,” he added. Mr Zelensky said later said on Telegram he had spoken to French President Emmanuel Macron about the environmental and humanitarian situation in the Kherson region. "I laid out Ukraine's general needs in dealing with the disaster. And we discussed the possibility of involving international mechanisms to investigate its causes," the president said. Meanwhile, in his first public comments on the disaster, President Putin repeated Moscow's line that Ukraine is to blame for destroying the Kakhovka dam. In a call with Turkish President Recep Tayyip Erdogan, Mr Putin alleged that Kyiv authorities had escalated "war crimes, openly using terrorist methods and staging acts of sabotage on the Russian territory," the Kremlin said in its account of the call. Read More Ukraine-Russia war news – live: Exploding mines float through floodwater after Kherson dam attack ‘Hard to control emotions’ amid Kherson flooding, says Ukrainian aid worker A dam bursts, but this barbaric attack will not halt Kyiv’s ‘big push’ Ukraine’s long-term future to be on agenda at Sunak and Biden meeting The Body in the Woods | An Independent TV Original Documentary The harrowing discovery at centre of The Independent’s new documentary

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