[Risk-adapted prostate cancer screening-update 2021]

Area of Science:

• Oncology
• Urology
• Preventive Medicine

Background:

• Prostate cancer (PCa) is a leading cause of cancer death in men, with no universally accepted screening strategy.
• The German Prostate Cancer Early Detection Study Based on a Baseline PSA Value in Young Men (PROBASE) was initiated in 2014 to address this gap.

Purpose of the Study:

• To evaluate a risk-adapted screening strategy for PCa based on baseline prostate-specific antigen (PSA) levels at age 45 or 50.
• To demonstrate the potential of this strategy as an alternative to population-based screening.

Main Methods:

• The PROBASE study utilizes risk stratification based on baseline PSA levels.
• Participants are categorized into low, intermediate, and high-risk groups for PCa screening.

Main Results:

• In study arm A, 23,301 participants were randomized.
• Baseline PSA testing classified 89.18% as low-risk, 9.32% as intermediate-risk, and 1.48% as high-risk, aligning with prior reports.

Conclusions:

• Baseline PSA-dependent, risk-adapted screening can potentially decrease overdiagnosis and overtreatment of insignificant PCa.
• Extended testing intervals for low-risk individuals may improve screening efficiency.
• Worldwide, several risk-adapted screening strategies are under investigation, with PROBASE contributing valuable data.