Gene‒Prostate-Specific-Antigen-Guided Personalized Screening for Prostate Cancer

Area of Science:

• Oncology
• Genetics
• Public Health

Background:

• Prostate cancer (PrCa) screening is crucial for early detection and mortality reduction.
• Integrating genetic information with prostate-specific antigen (PSA) testing offers a novel approach to personalized PrCa screening.

Purpose of the Study:

• To evaluate the effectiveness of a personalized, gene-PSA-guided screening strategy for PrCa.
• To compare mortality reduction and unnecessary testing rates between personalized, universal, and no screening programs.

Main Methods:

• A six-state Markov model incorporating genetic and PSA data was developed.
• A simulated randomized controlled trial compared personalized screening, universal screening, and a non-screening group.
• The model assessed personalized risk stratification for PrCa.

Main Results:

• Personalized screening demonstrated similar PrCa mortality reduction (22%) compared to universal screening (20%).
• The personalized approach reduced unnecessary PSA testing by 26% and avoided 2% of over-detection.
• Both screening strategies significantly outperformed the non-screening group.

Conclusions:

• Gene-PSA-guided personalized screening for PrCa effectively reduces mortality.
• This personalized strategy minimizes unnecessary PSA tests and over-detection without compromising screening benefits.
• Personalized screening represents an efficient alternative to universal screening for prostate cancer.