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Related Experiment Video

Updated: May 15, 2026

Microarray-based Identification of Individual HERV Loci Expression: Application to Biomarker Discovery in Prostate Cancer
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Microarray-based Identification of Individual HERV Loci Expression: Application to Biomarker Discovery in Prostate Cancer

Published on: November 2, 2013

Risk stratification in prostate cancer screening.

Monique J Roobol1, Sigrid V Carlsson

  • 1Department of Urology, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands. m.roobol@erasmusmc.nl

Nature Reviews. Urology
|December 19, 2012
PubMed
Summary

Prostate cancer screening remains controversial. While one study showed no mortality benefit, another found a 21% reduction with regular screening, suggesting a personalized approach is needed.

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Cancer detection in the European Randomised Study of Screening for Prostate Cancer (ERSPC).

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Diagnosis and Staging of Patients with Prostate Cancer: Report from the 2025 Advanced Prostate Cancer Consensus Conference (APCCC) Diagnostics.

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[Screening for prostate cancer; a screening program is favored over current opportunistic testing].

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From Evidence to Implementation: How Should We Screen for Prostate Cancer in the Modern Era?: Editorial to: Nguyen DD, Tadayon B, Lin L, et al. Effect of Prostate Cancer Screening with Prostate-specific Antigen Testing on Long-term Prostate Cancer-specific Mortality: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Eur Urol. 2026. In press. https://doi.org/10.1016/j.eururo.2026.04.005.

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Area of Science:

  • Urology
  • Oncology
  • Preventive Medicine

Background:

  • Prostate cancer screening is debated due to conflicting evidence on mortality benefits and harms.
  • The US Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial found no mortality difference with annual screening.
  • The European Randomised Study of Screening for Prostate Cancer showed a 21% reduction in mortality with 2-4 year screening intervals.

Purpose of the Study:

  • To evaluate the effectiveness and risks of prostate cancer screening.
  • To address the controversy surrounding prostate-specific antigen (PSA) testing.
  • To advocate for a personalized risk-assessment approach to screening.

Main Methods:

  • Review of major prostate cancer screening trials, including the US PLCO and the European ERSPC.
  • Analysis of mortality data and potential harms associated with PSA screening.
  • Discussion of risk stratification and personalized screening strategies.

Main Results:

  • Conflicting results from major trials regarding prostate cancer mortality reduction.
  • US Preventive Services Task Force recommends against routine PSA screening due to uncertain benefit-harm ratio.
  • PSA testing can benefit select individuals by enabling early detection of aggressive cancers.

Conclusions:

  • A 'one-size-fits-all' approach to prostate cancer screening is inadequate.
  • Personalized risk assessment is crucial to balance potential benefits against harms like overdiagnosis and overtreatment.
  • Tailoring PSA testing based on individual risk factors is necessary to optimize outcomes and minimize adverse effects.

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