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...

Full description

Saved in:
Bibliographic Details
Main Authors: Zaure Dushimova, Yerbolat Iztleuov, Gulnar Chingayeva, Abay Shepetov, Nagima Mustapayeva, Oxana Shatkovskaya, Marat Pashimov, Timur Saliev
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Diseases
Subjects:
Online Access:https://www.mdpi.com/2079-9721/13/6/167
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849432324833280000
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
work_keys_str_mv AT zauredushimova overdiagnosisandovertreatmentinprostatecancer
AT yerbolatiztleuov overdiagnosisandovertreatmentinprostatecancer
AT gulnarchingayeva overdiagnosisandovertreatmentinprostatecancer
AT abayshepetov overdiagnosisandovertreatmentinprostatecancer
AT nagimamustapayeva overdiagnosisandovertreatmentinprostatecancer
AT oxanashatkovskaya overdiagnosisandovertreatmentinprostatecancer
AT maratpashimov overdiagnosisandovertreatmentinprostatecancer
AT timursaliev overdiagnosisandovertreatmentinprostatecancer