Breakthrough Blood Test Achieves 100% Accuracy in Landmark Danish Study:

Glycan Score Revolutionizes Agressive Prostate Cancer Detection

Bottom Line Up Front: A groundbreaking new blood test called the "Glycan Score" has achieved 100% accuracy in distinguishing prostate cancer patients from healthy individuals in a Danish study, while also successfully differentiating between localized and metastatic disease—a capability that traditional PSA testing lacks.

Danish Researchers Crack the "Sugar Code" of Cancer

Researchers at Aarhus University and Aarhus University Hospital have developed a revolutionary blood test that could transform prostate cancer screening by analyzing the "sugar coating" patterns on PSA proteins rather than simply measuring PSA levels. In their landmark study published in Analytical Chemistry in 2024, the Glycan Score correctly identified 100 percent of prostate cancer cases in a 30-patient cohort, while traditional PSA testing achieved only 53% accuracy in the same group.

The breakthrough centers on glycosylation—the process by which sugar molecules attach to proteins. Cancer cells disrupt normal protein sugar patterns, creating distinctive "fingerprints" that can be detected in blood samples. Lead researcher Professor Elena Ferapontova and her team discovered that PSA's altered glycosylation patterns can accurately stratify primary and metastatic prostate cancers, something traditional PSA testing cannot accomplish.

How the Glycan Score Works

The test uses DNA aptamers—tiny synthetic molecules that specifically bind to both PSA and its sugar coating—in a bioelectronic assay to measure abnormal glycosylation levels. The resulting Glycan Score categorizes patients into three distinct groups:

• Healthy individuals: Glycan Score below 30% (likely cancer-free)
• Localized prostate cancer: Glycan Score between 39% and 64%
• Metastatic prostate cancer: Glycan Score above 72%

The higher the Glycan Score, the more aggressive the cancer, as worsening disease disrupts natural PSA-protein complexes in blood, exposing more sugar coating for detection.

Superior Performance Over Current Testing

The study's results highlight dramatic improvements over existing screening methods. While the Glycan Score achieved 100% accuracy in identifying all prostate cancer cases and distinguishing between localized and metastatic disease, PSA testing was only 53% accurate and could not differentiate between aggressive and less harmful cancers.

This superior performance addresses critical limitations of current PSA screening. Traditional PSA testing has major flaws, leading to both false alarms and missed diagnoses, which contributed to the U.S. Preventive Services Task Force recommending against routine PSA screening in 2012.

Addressing the Glycosylation Research Foundation

The Danish study builds upon decades of research into PSA glycosylation patterns. Previous studies have consistently shown that cancer-associated changes in protein glycosylation represent a fundamental characteristic of tumor progression, with multiple research teams documenting altered PSA sugar patterns in cancer patients.

Earlier research demonstrated that α2,3-sialylated PSA could separate high-risk prostate cancer patients from benign prostatic hyperplasia and low-risk cancers with 85.7% sensitivity and 95.5% specificity, achieving an area under the curve (AUC) of 0.97. Other studies have shown that core-fucosylated PSA achieved 36% specificity at 90% sensitivity in 252 men, while LacdiNAc-glycosylated PSA reached 48.6% specificity in 718 men.

Clinical Impact and Future Implications

With more than 1.4 million estimated prostate cancer cases worldwide in 2023, the demand for a cheaper, more accurate and user-friendly screening method is high. The Glycan Score could address several critical healthcare challenges:

Reducing Unnecessary Procedures: The test's ability to accurately distinguish cancer from benign conditions could dramatically reduce unnecessary biopsies, a major problem with current PSA screening.

Improved Risk Stratification: The test showed significant positive correlation with Gleason score (r=0.546, p<0.001), potentially improving cancer risk classification beyond what total PSA or %free PSA can achieve.

Better Treatment Monitoring: The technology could enable more precise monitoring of treatment responses in advanced cases.

Potential Applications for Active Surveillance and ADT Patients

The Glycan Score's ability to accurately distinguish between localized and metastatic disease, combined with its correlation to cancer aggressiveness, suggests several promising applications for patients currently managing prostate cancer:

Active Surveillance Monitoring: For men on active surveillance, the Glycan Score could provide a more reliable method to monitor disease progression than traditional PSA testing alone. Since the test correlates with Gleason score and can detect increasing aggressiveness, it might help identify patients whose cancer is transitioning from indolent to aggressive disease—the critical decision point for moving from surveillance to active treatment. Regular Glycan Score monitoring could potentially reduce the frequency of repeat biopsies while providing early warning of disease progression.

ADT Response Assessment: Patients undergoing androgen deprivation therapy (ADT) could benefit from Glycan Score monitoring to assess treatment effectiveness and detect early signs of resistance. Since PSA levels typically drop significantly during successful ADT—sometimes making traditional monitoring challenging—the Glycan Score's ability to detect cancer-specific glycosylation changes might provide additional insight into treatment response. As cancer cells develop resistance to hormone therapy, they often undergo metabolic changes that could alter protein glycosylation patterns, potentially making the Glycan Score an early indicator of treatment failure.

Castration-Resistant Progression Detection: The test's demonstrated ability to distinguish metastatic from localized disease could be particularly valuable for patients transitioning from hormone-sensitive to castration-resistant prostate cancer (CRPC). Early detection of this transition is crucial for timely treatment adjustments, and the Glycan Score might identify this progression before conventional imaging or PSA kinetics become apparent.

Reduced Imaging Frequency: For patients requiring regular monitoring, the Glycan Score could potentially reduce reliance on expensive imaging studies like bone scans or advanced MRI, while still providing reliable information about disease status and progression risk.

The Science Behind the Innovation

The original aptamer technology was developed by Professor Maria Jesus Lobo-Castañon at the University of Oviedo, with PhD student Ana Diaz-Fernandez designing the initial aptamer before joining the Aarhus research group. The Danish team adapted this technology specifically for aggressive cancer detection.

The researchers used an advanced dual-functional aptamer assay to quantify PSA glycosylation extent in cancer patients' serum, linking it to cancer-related breakage of PSA complexes with serum-circulating proteins.

Next Steps: Large-Scale Validation

While the initial results are promising, larger independent studies with several hundred patients are needed before the findings can be used in everyday medical practice. These trials represent a crucial step toward gaining approval from the FDA and European health authorities.

If fully realized, the technology could enable more accurate large-scale screening programs and provide a more reliable way to monitor treatment responses in advanced cases.

Broader Context in Prostate Cancer Biomarker Development

The Glycan Score represents part of a broader evolution in prostate cancer diagnostics. Recent advancements include the 4Kscore test and Prostate Health Index for distinguishing cancer from benign conditions, and urinary biomarker tests such as PCA3, MyProstateScore, SelectMDx, and ExoDx Prostate IntelliScore test for risk stratification.

Emerging biomarkers, including non-coding RNAs, circulating tumor DNA, and PSA glycosylation, offer valuable insights into prostate cancer biology, enabling personalized treatment strategies.

Looking Forward

For years, the idea of a simple and highly accurate blood test for prostate cancer felt more like science fiction than reality. The Glycan Score's exceptional performance in this Danish study suggests that vision may soon become reality, potentially transforming how we screen for and manage one of the most common cancers affecting men worldwide.

The research team eagerly awaits larger validation studies that could bring this technology to clinical practice, offering hope for more accurate early detection and better outcomes for prostate cancer patients globally.

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Sources and Citations

1. Díaz-Fernández, A., et al. (2024). Liquid-Biopsy Glycan Score Biomarker Accurately Indicates and Stratifies Primary and Metastatic Prostate Cancers. Analytical Chemistry, 96(47), 18815-18823. https://doi.org/10.1021/acs.analchem.4c04316
2. Ferapontova, E. (2024). A Sweet Breakthrough in Prostate Cancer Screening. Science Nordic. https://www.sciencenordic.com/cancer-cancer-treatment-denmark/a-sweet-breakthrough-in-prostate-cancer-screening/2527924
3. Llop, E., et al. (2016). Improvement of Prostate Cancer Diagnosis by Detecting PSA Glycosylation-Specific Changes. Theranostics, 6(8), 1190-1204. https://www.thno.org/v06p1190.htm
4. He, K., et al. (2024). Decoding the glycoproteome: a new frontier for biomarker discovery in cancer. Journal of Hematology & Oncology, 17(1), 12. https://doi.org/10.1186/s13045-024-01532-x
5. Liu, Y., et al. (2025). Liquid Biomarkers in Prostate Cancer Diagnosis: Current Status and Emerging Prospects. World Journal of Men's Health, 43(1), 8-27. https://doi.org/10.5534/wjmh.230386
6. Gilgunn, S., et al. (2013). Aberrant PSA glycosylation—a sweet predictor of prostate cancer. Nature Reviews Urology, 10(2), 99-107. https://doi.org/10.1038/nrurol.2012.258
7. Meany, D.L., et al. (2009). Glycoproteomics for prostate cancer detection: changes in serum PSA glycosylation patterns. Journal of Proteome Research, 8(2), 613-619. https://doi.org/10.1021/pr8007045
8. Ferrer-Batallé, M., et al. (2020). Characterisation of the main PSA glycoforms in aggressive prostate cancer. Scientific Reports, 10, 18974. https://doi.org/10.1038/s41598-020-75526-3

This article was compiled using the latest available research on PSA glycosylation and the Glycan Score blood test, with particular focus on the groundbreaking Danish study published in Analytical Chemistry in 2024.

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Glycan Score Blood Test Accurately Detects and Stratifies Prostate Cancer in Landmark Danish Study