In a new article, researchers from the International Agency for Research on Cancer (IARC) and partner institutions describe a novel method of screening for prostate cancer that reduces overdiagnosis of this disease. The article was published in the journal Nature Reviews Urology.
The researchers propose a risk-adapted strategy for prostate cancer screening with improved use of prostate-specific antigen (PSA) levels, in combination with age, prostate volume, and the application of prostate cancer risk calculators. This combination, used with advanced detection techniques such as magnetic resonance imaging (MRI) and targeted biopsy for men who have significant lesions on MRI, can reduce overdiagnosis of prostate cancer. The risk-adapted strategy enables improved stratification of men with prostate cancer and avoidance of unnecessary diagnostic procedures. Tests for newly discovered biomarkers that are becoming available will enable further improvements in risk stratification.
Contradictory outcomes of randomized controlled trials of current PSA-based screening methods and the resulting overdiagnosis led to recommendations against prostate cancer screening, although re-evaluation of the data showed that PSA-based screening reduces prostate cancer mortality. Improved screening methods with reduced rates of overdiagnosis could enable the introduction of more effective prostate cancer screening programmes with better benefit-to-harm ratios.
Van Poppel H, Albreht T, Basu P, Hogenhout R, Collen S, Roobol M.
Serum PSA-based early detection of prostate cancer in Europe and globally: past, present and future
Nat Rev Urol, Published online 16 August 2022;
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