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Summary statement on screening for prostate cancer in Europe
Eveline A M Heijnsdijk1, Chris H Bangma2, Josep M Borràs3
1Department of Public Health, Erasmus Medical Center, Wytemaweg 80, CN Rotterdam, 3015, The Netherlands.
International Journal of Cancer
|October 13, 2017
Summary
Prostate-Specific Antigen (PSA) screening significantly reduces prostate cancer deaths. Targeted screening in younger men (55-59) with active surveillance for low-risk cases offers benefits and potential cost savings.
Area of Science:
- Urology
- Oncology
- Public Health
Background:
- Prostate-Specific Antigen (PSA) screening has demonstrated efficacy in reducing prostate cancer mortality.
- Concerns regarding overdiagnosis and overtreatment necessitate optimized screening strategies.
Purpose of the Study:
- To evaluate the benefits and harms of PSA-based prostate cancer screening.
- To explore cost-effective screening programs and the role of active surveillance.
Main Methods:
- Analysis of data from the European Randomised Study of Screening for Prostate Cancer (ERSPC).
- Assessment of limited screening programs (ages 55-59) and active surveillance protocols.
- Consideration of emerging biomarkers and magnetic resonance imaging (MRI) for disease discrimination.
Main Results:
- PSA screening leads to a significant reduction in prostate cancer mortality.
- Screening benefits can outweigh harms when stopped at older ages, preventing overdiagnosis.
- Limited screening programs combined with active surveillance may be cost-saving compared to opportunistic testing.
Conclusions:
- Optimized PSA screening, particularly in younger age groups (55-59), coupled with active surveillance, offers a favorable risk-benefit profile.
- Future advancements in biomarkers and imaging will further refine prostate cancer management.
- Continued feasibility studies for high-quality PSA screening are warranted, without delaying current optimized testing strategies.