‘Man Van’ Diagnoses Nonmetastatic Prostate Cancers

Among more than 3000 men from low-income communities who were screened for various health issues at mobile clinics, one had stage IV and none had metastatic prostate cancer.

These were among the findings of a study presented by lead author Masood Moghul, MBBS, at the 2025 American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium (GUCS) 2025 in San Francisco.

The overall diagnostic rates of prostate cancer and clinically significant prostate cancers were 3.1% and 2.8%, respectively. In all, 310 men were referred for further investigation for prostate cancer, and 94 prostate cancers were diagnosed. Of these, 81 (86.2%) were determined to be clinically significant, with a Gleason Grade ≥ 2 and > 5% pattern 4.

The study, which ran from January 2023 to January 2024, included 3379 men with a median age of 59 years being screened for obesity, diabetes, hypertension, and prostate-specific antigen (PSA) at Man Van mobile health outreach clinics.

Of the attendees, 36.4% were non-White individuals, including 16.7% who were Black individuals, a proportion higher than that of the background UK population (11%), noted Moghul, of the Royal Marsden Hospital in London, England.

Of the 94 men diagnosed with prostate cancer, 25 were managed with active surveillance, 2 were managed with cryotherapy, 2 had low dose-rate brachytherapy, 39 underwent robotic prostatectomy, and 26 underwent radical radiotherapy.

The Man Van outreach clinics are designed to reach men who are living in areas where median incomes are low and who are ethnic minorities. The program offers nurse-led health checks that include measures of body-mass index, blood pressure, glycosylated A1c, and PSA.

Men found to have elevated PSA are then referred directly to secondary care for further testing and treatment, if necessary.

“We know that if you’re from an underserved population, then that has a big impact on your life expectancy. It’s a key determinant of how long you’re going to live and how healthy your life is going to be. And we know that certain groups, particularly if you’re from an ethnic minority, are more likely to be from this kind of underserved population,” said Moghul, in an online media briefing held prior to ASCO meeting.

Moghul noted that in the United Kingdom, specifically, men of minority ethnicities or low economic status have a 14% higher prostate cancer mortality rate and a 29% higher risk for presenting with metastatic disease than White men of high socioeconomic status.

Although prostate cancer screening programs are often criticized for over-diagnosing clinically insignificant cancers that can in turn lead to unnecessary treatment, the Man Van’s high diagnostic rate of clinically significant cancers indicates that the strategy of targeting high-risk men is on the right track, he said during the media briefing.

Moghul and his team conducted a pilot study of the Man Van in 2022 and used the information from that successful pilot to optimize care for phase 2. The optimization included sending multiple text messages to participants to reduce nonattendance rates (29% were no-shows in phase 1), improving the overall efficiency by implementing online registrations and pre-visit questionnaires, and reducing appointment times from 30 minutes to 15 minutes to improve the initial limited patient throughput rate of 12 per day to more than 100 per week.

‘Exemplary’ Model

“I think the mobile van, Man Van prostate cancer screening program is exemplary because it really demonstrates that we can have a patient-centered and community-centered approach and meet patients and individuals in the community where they are, as opposed to where we are with a more provider-centered or institution-centered approach,” commented invited discussant Curtiland Deville, MD, a radiation oncologist at Johns Hopkins University in Baltimore.

However, “a main question is how generalizable is this approach to other environments, in particular with different healthcare delivery models?” he added.

For example, such programs may be easier to implement in the United Kingdom under the National Health Service than in the United States with its mix of insured, underinsured, and uninsured patients, “and therefore navigation becomes a big issue when we want to engage in these community-based approaches, and how do we insure that those who are being screened positive are getting on to those next steps of care?,” he said.

Julie R. Gralow, MD, chief medical officer of ASCO, who moderated the briefing, added that “this is a very nice model of patient-centric care: Coming to the patient, to the community, which removes a lot of the barriers, especially for our underserved populations.”

US Experience

There are currently at least two similar mobile PSA screening cancer programs in the United States: The Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine’s Game Changer program, which brings prostate cancer screenings to men in South Florida, and the Mt. Sinai Robert F. Smith Mobile Prostate Cancer Screening program, which serves neighborhoods in Harlem, the Upper East Side, and Queens in New York City.

As investigators from Sylvester’s Gamer Changer program reported in April 2023 in The Journal of Urology, they used county-level data to identify populations with disproportionately high cancer burdens and targeted these areas in Miami-Dade and neighboring counties with a mobile PSA screening clinics, with a goal of reaching a minimum of 250 men within 6 months.

In a preliminary report, the authors noted that of 41 men screened, 83% self-reported as being of African-American heritage and 10% as being Hispanic or Latino individuals. Nearly one fourth of the sample (22%) had a PSA level > 3 ng/ml and warranted further investigations.

Men who request prostate cancer screening through the Game Changer program are invited to participate in a research protocol that involves blood, urine, and saliva collections for future epigenetic and biomarker research, and the participants are also asked to fill out questionnaires about their known risk factors, barriers to care, and current attitudes toward prostate cancer screening.

Game Changer screened 1350 persons in total for different cancers/cancer risk factors last year, Erin Kobetz, PhD, MPH, told Medscape Medical News. Also in 2024, the team screened 419 men for prostate cancer, specifically, with 40 having been abnormal, and all men with abnormal findings having been “navigated to timely and appropriate follow up,” said Kobetz, associate director, Community Outreach and Engagement at the Sylvester Comprehensive Cancer Center, Miami.

The Mt. Sinai mobile van was launched in 2022 and screened more than 2000 men within its first year. In all, 17% of men screened had PSA levels > 2.5 ng/ml. As of the most recent report more than 4400 men had been screened, with approximately 19% having PSA levels above the 2.5 ng/ml threshold.

The study presented at the 2025 American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium was supported by the UK National Health Service. Moghul disclosed receiving leadership positions with Diva Care and YKT Health/Dales Pharmacy, and honoraria from Bayer. Deville and Gralow had no relevant conflicts of interest.

Neil Osterweil, an award-winning medical journalist, is a long-standing and frequent contributor to Medscape Medical News.