Overdiagnosis and Overtreatment in Prostate Cancer
Prostate cancer (PCa) is one of the most common malignancies among men worldwide. While prostate-specific antigen (PSA) screening has improved early detection, it has also led to significant challenges regarding overdiagnosis and overtreatment. Overdiagnosis involves identifying indolent tumors unli...
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MDPI AG
2025-05-01
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| author | Zaure Dushimova Yerbolat Iztleuov Gulnar Chingayeva Abay Shepetov Nagima Mustapayeva Oxana Shatkovskaya Marat Pashimov Timur Saliev |
| author_facet | Zaure Dushimova Yerbolat Iztleuov Gulnar Chingayeva Abay Shepetov Nagima Mustapayeva Oxana Shatkovskaya Marat Pashimov Timur Saliev |
| author_sort | Zaure Dushimova |
| collection | DOAJ |
| description | Prostate cancer (PCa) is one of the most common malignancies among men worldwide. While prostate-specific antigen (PSA) screening has improved early detection, it has also led to significant challenges regarding overdiagnosis and overtreatment. Overdiagnosis involves identifying indolent tumors unlikely to affect a patient’s lifespan, while overtreatment refers to unnecessary interventions that can cause adverse effects such as urinary incontinence, erectile dysfunction, and a reduced quality of life. This review highlights contributing factors, including the limitations of PSA testing, advanced imaging techniques like multi-parametric MRI (mpMRI), medical culture, and patient expectations. The analysis emphasizes the need for refining screening protocols, integrating novel biomarkers (e.g., PCA3, TMPRSS2-ERG), and adopting conservative management strategies such as active surveillance to minimize harm. Risk-based screening and shared decision-making are critical to balancing the benefits of early detection with the risks of unnecessary treatment. Additionally, systemic healthcare factors like financial incentives and malpractice concerns exacerbate overuse. This review advocates for updated clinical guidelines and personalized approaches to optimizing patient outcomes while reducing the strain on healthcare resources. Addressing overdiagnosis and overtreatment through targeted interventions will improve the quality of life for PCa patients and enhance the efficiency of healthcare systems. |
| format | Article |
| id | doaj-art-0ba0db1fd5ad4a92a156d3f15a71c7c7 |
| institution | Kabale University |
| issn | 2079-9721 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diseases |
| spelling | doaj-art-0ba0db1fd5ad4a92a156d3f15a71c7c72025-08-20T03:27:23ZengMDPI AGDiseases2079-97212025-05-0113616710.3390/diseases13060167Overdiagnosis and Overtreatment in Prostate CancerZaure Dushimova0Yerbolat Iztleuov1Gulnar Chingayeva2Abay Shepetov3Nagima Mustapayeva4Oxana Shatkovskaya5Marat Pashimov6Timur Saliev7Department of Fundamental Medicine, Al-Farabi Kazakh National University, Almaty 050040, KazakhstanNJSC “Marat Ospanov West Kazakhstan Medical University”, Aktobe 030019, KazakhstanS.D. Asfendiyarov Kazakh National Medical University, Tole Bi Street 94, Almaty 050000, KazakhstanS.D. Asfendiyarov Kazakh National Medical University, Tole Bi Street 94, Almaty 050000, KazakhstanS.D. Asfendiyarov Kazakh National Medical University, Tole Bi Street 94, Almaty 050000, KazakhstanNational Research Oncology Center, Astana 020000, KazakhstanJSC “Research Institute of Cardiology and Internal Diseases”, Almaty 050000, KazakhstanS.D. Asfendiyarov Kazakh National Medical University, Tole Bi Street 94, Almaty 050000, KazakhstanProstate cancer (PCa) is one of the most common malignancies among men worldwide. While prostate-specific antigen (PSA) screening has improved early detection, it has also led to significant challenges regarding overdiagnosis and overtreatment. Overdiagnosis involves identifying indolent tumors unlikely to affect a patient’s lifespan, while overtreatment refers to unnecessary interventions that can cause adverse effects such as urinary incontinence, erectile dysfunction, and a reduced quality of life. This review highlights contributing factors, including the limitations of PSA testing, advanced imaging techniques like multi-parametric MRI (mpMRI), medical culture, and patient expectations. The analysis emphasizes the need for refining screening protocols, integrating novel biomarkers (e.g., PCA3, TMPRSS2-ERG), and adopting conservative management strategies such as active surveillance to minimize harm. Risk-based screening and shared decision-making are critical to balancing the benefits of early detection with the risks of unnecessary treatment. Additionally, systemic healthcare factors like financial incentives and malpractice concerns exacerbate overuse. This review advocates for updated clinical guidelines and personalized approaches to optimizing patient outcomes while reducing the strain on healthcare resources. Addressing overdiagnosis and overtreatment through targeted interventions will improve the quality of life for PCa patients and enhance the efficiency of healthcare systems.https://www.mdpi.com/2079-9721/13/6/167prostate cancerPSA screeningoverdiagnosisovertreatmentcancer treatmenthealthcare resources |
| spellingShingle | Zaure Dushimova Yerbolat Iztleuov Gulnar Chingayeva Abay Shepetov Nagima Mustapayeva Oxana Shatkovskaya Marat Pashimov Timur Saliev Overdiagnosis and Overtreatment in Prostate Cancer Diseases prostate cancer PSA screening overdiagnosis overtreatment cancer treatment healthcare resources |
| title | Overdiagnosis and Overtreatment in Prostate Cancer |
| title_full | Overdiagnosis and Overtreatment in Prostate Cancer |
| title_fullStr | Overdiagnosis and Overtreatment in Prostate Cancer |
| title_full_unstemmed | Overdiagnosis and Overtreatment in Prostate Cancer |
| title_short | Overdiagnosis and Overtreatment in Prostate Cancer |
| title_sort | overdiagnosis and overtreatment in prostate cancer |
| topic | prostate cancer PSA screening overdiagnosis overtreatment cancer treatment healthcare resources |
| url | https://www.mdpi.com/2079-9721/13/6/167 |
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