Prostate‐specific antigen‐based prostate cancer screening: Past and future

Abstract

Prostate-specific antigen-based prostate cancer screening remains a controversial topic. Up to now, there is worldwide consensus on the statement that the harms of populationbased screening, mainly as a result of overdiagnosis (the detection of clinically insignificant tumors that would have never caused any symptoms), outweigh the benefits. However, worldwide opportunistic screening takes place on a wide scale. The European Randomized Study of Screening for Prostate Cancer showed a reduction in prostate cancer mortality through prostate-specific antigen based-screening. These population-based data need to be individualized in order to avoid screening in those who cannot benefit and start screening in those who will. For now, lacking a more optimal screening approach, screening should only be started after the process of shared decision-making. The focus of future research is the reduction of unnecessary testing and overdiagnosis by further research to better biomarkers and the value of the multiparametric magnetic resonance imaging, potentially combined in already existing prostate-specific antigen-based multivariate risk prediction models.

Total, free, and complexed prostate-specific antigen levels among US men, 2007–2010

“…Hayes and Barry recently reviewed randomized trials and modeling studies of screening for prostate cancer with the PSA test and found that two major trials have examined the role of PSA in screening for prostate cancer [5]. The European Randomized Study of Screening for Prostate Cancer (ERSPC) found a reduction in prostate cancer mortality using PSA testing [6,7]. The Prostate, Lung, Colorectal and Ovarian (PLCO) screening trial did not show a prostate cancerspecific mortality benefit with PSA screening [8,9].…”

Differences in cancer characteristics of Chinese patients with prostate cancer who present with different symptoms

“…Moreover, more than half of those patients diagnosed by case finding belonged to intermediateor higher-risk groups for which active treatment was recommended. 6,7 One of the concerns is the risk of overdiagnosis and overtreatment of low-risk cancer that may result in more potential harm than benefit to patients. [8][9][10] There are many types of prostate cancer screening approaches.…”

Re: Prostate‐specific antigen‐based prostate cancer screening: Past and future

“…1 In the well-known Merenstein case from 1999, a general practice resident saw a >50-year-old male patient for a checkup. 2 In accordance with guidelines, prostate-specific antigen (PSA) test risks and benefits were discussed, the patient declined to have it done, and the process was formally documented.…”