{"entity":{"id":"transform-prostate","kind":"trial","name":"TRANSFORM","aka":["Trial of Randomised Approaches for National Screening FOR Men","ISRCTN13801649"],"tldr":"The trial that will decide whether Britain screens for prostate cancer, designed with the screening committee's input and built from the start to answer the question about Black men that every previous trial was too white to answer.","summary":"TRANSFORM exists because the UK National Screening Committee's March 2026 review could not answer two questions. The first is whether any modern screening pathway does more good than harm in the general population: the committee's modelling said no for PSA alone, because around 40 to 50 percent of screen-detected cancers are slow growing and at age 60 roughly half of screen-detected cases would be overdiagnosed. The second is whether it would do more good than harm in Black men, where the committee found the evidence too thin to say either way.\n\nThe trial randomises men, before consent in one of its two designs, between four screening strategies and a control group following usual care. The registry record does not enumerate the four; Prostate Cancer UK and Imperial describe them as combinations of PSA testing, a polygenic risk test and fast biparametric MRI. Stage 1 is a single screening round with a target of 16,000; stage 2 runs at least two rounds. Its eligibility rules are the point: the general invitation starts at 50, but men of Black ethnicity are invited from 45, and the design carries a floor of at least one in ten stage 1 invitations going to Black men. The government said on 2 June 2026 that it would fund the expansion so that from stage 2 all eligible Black men would be invited. The committee has said it will work with the trial team to resolve the uncertainty on Black men as soon as good data exist.","status":"recruiting","asOf":"2026-09-25","links":[{"label":"ISRCTN13801649","url":"https://www.isrctn.com/ISRCTN13801649"},{"label":"Prostate Cancer UK: the TRANSFORM trial","url":"https://prostatecanceruk.org/research/transform-trial"},{"label":"UK National Screening Committee coversheet, March 2026","url":"https://view-health-screening-recommendations.service.gov.uk/review/prostate-cancer-screening-modelling-report-2025/download-documents/cover_sheet/"}],"tags":["uk","prostate","screening"],"related":[],"cancers":["prostate","prostate-low-risk"],"sections":["early-detection"],"technologies":["mri","prostate-screening-psa-mri"],"targets":[],"drugs":[],"companies":[],"institutions":["imperial-cancer-centre","uclh","prostate-cancer-uk"],"pathways":[],"terms":["psa"],"trials":[],"people":["hashim-ahmed","rakesh-heer","ros-eeles"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"ISRCTN13801649","phase":"3","setting":"Men aged 50 to 74 in the general population, plus men aged 45 to 49 who are recorded in their GP list as being of Black ethnicity or who are on the learning disability quality outcomes framework register: a multi-arm multi-stage randomised platform trial comparing four prostate health checks against usual care, using two pre-consent randomisation designs, one of them a Zelen design. The ISRCTN record was assigned on 21 October 2025 and last updated on 30 December 2025; recruitment opened on 21 November 2025 and is due to close on 1 June 2027, with an overall end date of 1 December 2027","sponsor":"Imperial College Healthcare NHS Trust and University College London Hospitals NHS Foundation Trust, funded by Prostate Cancer UK and the National Institute for Health and Care Research","enrolled":16000,"enrolledBasis":"registry","outcomes":[]},"route":"/trials/transform-prostate/","neighbours":{"cancer":[{"id":"prostate-low-risk","kind":"cancer","name":"Localised prostate cancer, very low and low risk","route":"/cancers/prostate-low-risk/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"technology":[{"id":"mri","kind":"technology","name":"MRI","route":"/technologies/mri/"},{"id":"prostate-screening-psa-mri","kind":"technology","name":"PSA and MRI-first prostate cancer screening","route":"/technologies/prostate-screening-psa-mri/"}],"institution":[{"id":"imperial-cancer-centre","kind":"institution","name":"Imperial College Healthcare NHS Trust / Imperial College London Cancer Research","route":"/institutions/imperial-cancer-centre/"},{"id":"prostate-cancer-uk","kind":"institution","name":"Prostate Cancer UK","route":"/institutions/prostate-cancer-uk/"},{"id":"uclh","kind":"institution","name":"University College London Hospitals / UCL Cancer Institute","route":"/institutions/uclh/"}],"term":[{"id":"psa","kind":"term","name":"PSA (prostate-specific antigen)","route":"/terms/psa/"}],"person":[{"id":"hashim-ahmed","kind":"person","name":"Hashim U. Ahmed","route":"/people/hashim-ahmed/"},{"id":"rakesh-heer","kind":"person","name":"Rakesh Heer","route":"/people/rakesh-heer/"},{"id":"ros-eeles","kind":"person","name":"Rosalind Eeles","route":"/people/ros-eeles/"}]}}