The Case for Tailored Prostate Cancer Screening: An NCCN Perspective

Area of Science:

• Oncology
• Public Health
• Diagnostic Medicine

Background:

• Clinical evidence supports prostate cancer screening and early detection in select populations.
• A key challenge is distinguishing aggressive, curable cancers from indolent ones to avoid overtreatment.

Purpose of the Study:

• To outline an evidence-based strategy for prostate cancer screening.
• To balance the benefits of early diagnosis with the risks of overdetection and overtreatment.

Main Methods:

• Utilizing a tailored approach for population screening in counseled men.
• Employing judicious prostate-specific antigen (PSA) testing.
• Considering newer biomarkers like % free PSA, 4Kscore, prostate health index, PCA3, and multiparametric MRI for improved specificity.

Main Results:

• An evidence-based strategy can reduce prostate cancer mortality.
• Judicious PSA testing and consideration of advanced biomarkers can limit the overdetection of clinically insignificant disease.

Conclusions:

• A tailored screening approach with PSA testing and advanced biomarkers offers a public health benefit.
• This strategy aims to maximize the detection of curable prostate cancer while minimizing the diagnosis of indolent disease.