Globally, prostate cancer is the second most frequently diagnosed cancer and the fifth-leading cause of cancer-related death among men—and the leading cause of cancer-related death in Central America and sub-Saharan Africa. Four years ago, British researchers launched the “Man Van” pilot mobile prostate screening clinic to enable high-risk male patients from deprived communities and ethnic minorities in Greater London increased access to health care to address inequalities that impact cancer outcomes.

The results from a large cohort of participants in the current Man Van phase II study showed that mobile screening for patients at high-risk of prostate cancer was effective in addressing barriers to cancer screening and in detecting clinically significant prostate cancer, as well as other health conditions. The study by Moghul et al is being presented during the 2025 ASCO Genitourinary Cancers Symposium, February 13 to 15, in San Francisco (Abstract 317).

Study Methodology

A nurse-led mobile clinical unit was dispatched to disadvantaged community locations in Greater London based on Index Multiple Deprivation (IMD) data with the goal of identifying men at high-risk of developing prostate cancer, and recommending them for additional testing. Between January 2023 and January 2024, 3,379 men attended a Man Van clinic (nonattendance rate of 15.1%). The median age of attendees was 59 years (age range = 39–97); 36.4% were non-White, including 16.7% of men who were Black. The median IMD rank was within the sixth lowest decile. For the IMD, individuals who score a rank of 1 face the most deprivations and those with a 10 face the least.

Results

The clinic referred 310 men for prostate cancer investigations, and 262 had prostate magnetic resonance imaging (MRI) scans, which were given a score on the Prostate Imaging Reporting and Data Systems (PI-RADS) scale. In this group of men, 139 (53.1%) had a PI-RADS score of 1 or 2, indicating a very low or low likelihood of prostate cancer; 35 (13.4%) had a PI-RADS score of 3, indicating 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, indicating a high or very high likelihood of prostate cancer; and 3 (1.1%) had scans that could not be scored for technical reasons.

Of those individuals who had prostate MRIs, 127 patients (48.5%) underwent a prostate biopsy, and 94 (74.0%) were diagnosed with prostate cancer. Of those patients, 81 (86.2%) had clinically significant disease that was grade 2 out of 5 or higher. None of the patients diagnosed had metastatic prostate cancer, with only one diagnosed with a stage of T4. The overall diagnostic rate of clinically significant disease was 2.8%.

Of the men diagnosed with prostate cancer (N = 94), 25 (26.6%) were managed with active surveillance; 2 (2.1%) were managed with cryotherapy; 2 (2.1%) were managed with low dose-rate brachytherapy; 39 (41.5%) underwent robotic prostatectomy; and 26 (27.7%) underwent radiotherapy.

Prostate cancer was not the only illness diagnosed by the Man Van. There were 59 patients who were found to have blood in their urine, and referred to a specialist within 2 weeks of the diagnosis. In addition, one patient was diagnosed with bladder cancer, 43 patients (2%) were diagnosed with diabetes, and 207 patients (11%) were diagnosed with prediabetes.

“The Man Van initiative is a novel method of linking primary and secondary care for a range of health checks, including prostate-specific antigen (PSA) [screening]. With a streamlined and more efficient service, we have maintained high uptakes for health checks [and] a willingness to engage with health improvement measures from deprived and ethnic minority groups. As well as comparatively high levels of prostate cancers diagnosed at early stages, high levels of other health conditions were found, improving the economic value of the service,” concluded the study authors.

Clinical Significance

“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,” said lead author of this study Masood Moghul, MBBS, Urology Fellow at the Institute of Cancer Research in London, in a statement. “We effectively recruited from high-risk groups of men in the UK and testing those men resulted in high rates of diagnoses of clinically significant prostate cancer, illustrating the effectiveness of a mobile facility for detecting prostate cancer in these groups.”

In presenting ASCO’s perspective on the study’s results, Curtiland Deville, MD, Medical Director of the Johns Hopkins Proton Therapy Center, said “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 health care.”

Disclosures: Funding for this study was provided by the Royal Marsden Hospital NHS Trust. For full disclosures of the study authors, visit coi.asco.org.