SIU-ICUD: Screening and Early Detection of Prostate Cancer

<b>Background/Objectives:</b> Randomised trials show that screening with prostate-specific antigen (PSA) and systematic prostate biopsies can reduce prostate cancer mortality but leads to high rates of overdiagnosis. Today, improved diagnostic methods more selectively detect potentially...

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Main Authors: Ola Bratt, Mohamed Jalloh, Anwar R. Padhani, Paul F. Pinsky, Hein Van Poppel, Weranja Ranasinghe, Kamran Zargar-Shoshtari, Kai Zhang, Anssi Auvinen
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Société Internationale d’Urologie Journal
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Online Access:https://www.mdpi.com/2563-6499/6/3/36
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author Ola Bratt
Mohamed Jalloh
Anwar R. Padhani
Paul F. Pinsky
Hein Van Poppel
Weranja Ranasinghe
Kamran Zargar-Shoshtari
Kai Zhang
Anssi Auvinen
author_facet Ola Bratt
Mohamed Jalloh
Anwar R. Padhani
Paul F. Pinsky
Hein Van Poppel
Weranja Ranasinghe
Kamran Zargar-Shoshtari
Kai Zhang
Anssi Auvinen
author_sort Ola Bratt
collection DOAJ
description <b>Background/Objectives:</b> Randomised trials show that screening with prostate-specific antigen (PSA) and systematic prostate biopsies can reduce prostate cancer mortality but leads to high rates of overdiagnosis. Today, improved diagnostic methods more selectively detect potentially lethal, high-grade prostate cancer. <b>Methods:</b> This is a narrative review of modern diagnostic methods, ongoing trials, national policies and knowledge gaps related to screening and early detection of prostate cancer. <b>Results:</b> Screening intervals can be prolonged in men with PSA values below around 1 ng/mL as these men are at very low long-term risk of prostate cancer death. Overdiagnosis can be reduced by magnetic resonance imaging (MRI) and lesion-targeted prostate biopsies. Risk calculators and ancillary biomarkers can select men for further investigation and thereby reduce resource needs. These new methods are evaluated in large, randomised screening trials. The remaining knowledge gaps include optimal PSA cut-offs, screening intervals, start and stop ages, and the long-term balance between benefits and harm. Until recently, almost no national healthcare authority recommended population-based screening for prostate cancer. Now, the European Union Council recommends an evaluation of the feasibility of organised, risk-stratified screening. This has led to several pilot projects. In some other parts of the world, such as sub-Saharan Africa and the Caribbean, such initiatives are lacking despite high prostate cancer mortality rates. <b>Conclusions:</b> Risk-stratified prostate cancer screening including MRI and targeted biopsy reduces overdiagnosis. Results from ongoing research are needed to optimise screening protocols and to define long-term benefits and harms. Initiatives for early detection and screening are emerging across the world but are still lacking in many countries with high prostate cancer mortality.
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spelling doaj-art-fe106eedbb1943a2832e294d08f7aa882025-08-20T03:29:44ZengMDPI AGSociété Internationale d’Urologie Journal2563-64992025-06-01633610.3390/siuj6030036SIU-ICUD: Screening and Early Detection of Prostate CancerOla Bratt0Mohamed Jalloh1Anwar R. Padhani2Paul F. Pinsky3Hein Van Poppel4Weranja Ranasinghe5Kamran Zargar-Shoshtari6Kai Zhang7Anssi Auvinen8Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 46 Gothenburg, SwedenDepartment of Surgery, Universite Cheikh Anta Diop de Dakar, Dakar BP 206, SenegalPaul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood HA6 2RN, UKDivision of Cancer Prevention, National Cancer Institute, Bethesda, MD 20892, USADepartment of Urology, Katholieke Universiteit Leuven, 3000 Leuven, BelgiumDepartment of Urology, Monash Health, Melbourne, VIC 3168, AustraliaDepartment of Urology, Auckland City Hospital, Auckland 1023, New ZealandDepartment of Urology, Beijing United Family Hospital and Clinics, Beijing 100016, ChinaHealth Sciences, Faculty of Social Sciences, Tampere University, 33520 Tampere, Finland<b>Background/Objectives:</b> Randomised trials show that screening with prostate-specific antigen (PSA) and systematic prostate biopsies can reduce prostate cancer mortality but leads to high rates of overdiagnosis. Today, improved diagnostic methods more selectively detect potentially lethal, high-grade prostate cancer. <b>Methods:</b> This is a narrative review of modern diagnostic methods, ongoing trials, national policies and knowledge gaps related to screening and early detection of prostate cancer. <b>Results:</b> Screening intervals can be prolonged in men with PSA values below around 1 ng/mL as these men are at very low long-term risk of prostate cancer death. Overdiagnosis can be reduced by magnetic resonance imaging (MRI) and lesion-targeted prostate biopsies. Risk calculators and ancillary biomarkers can select men for further investigation and thereby reduce resource needs. These new methods are evaluated in large, randomised screening trials. The remaining knowledge gaps include optimal PSA cut-offs, screening intervals, start and stop ages, and the long-term balance between benefits and harm. Until recently, almost no national healthcare authority recommended population-based screening for prostate cancer. Now, the European Union Council recommends an evaluation of the feasibility of organised, risk-stratified screening. This has led to several pilot projects. In some other parts of the world, such as sub-Saharan Africa and the Caribbean, such initiatives are lacking despite high prostate cancer mortality rates. <b>Conclusions:</b> Risk-stratified prostate cancer screening including MRI and targeted biopsy reduces overdiagnosis. Results from ongoing research are needed to optimise screening protocols and to define long-term benefits and harms. Initiatives for early detection and screening are emerging across the world but are still lacking in many countries with high prostate cancer mortality.https://www.mdpi.com/2563-6499/6/3/36prostate cancerscreeningdiagnosismortalityoverdiagnosis
spellingShingle Ola Bratt
Mohamed Jalloh
Anwar R. Padhani
Paul F. Pinsky
Hein Van Poppel
Weranja Ranasinghe
Kamran Zargar-Shoshtari
Kai Zhang
Anssi Auvinen
SIU-ICUD: Screening and Early Detection of Prostate Cancer
Société Internationale d’Urologie Journal
prostate cancer
screening
diagnosis
mortality
overdiagnosis
title SIU-ICUD: Screening and Early Detection of Prostate Cancer
title_full SIU-ICUD: Screening and Early Detection of Prostate Cancer
title_fullStr SIU-ICUD: Screening and Early Detection of Prostate Cancer
title_full_unstemmed SIU-ICUD: Screening and Early Detection of Prostate Cancer
title_short SIU-ICUD: Screening and Early Detection of Prostate Cancer
title_sort siu icud screening and early detection of prostate cancer
topic prostate cancer
screening
diagnosis
mortality
overdiagnosis
url https://www.mdpi.com/2563-6499/6/3/36
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