Risk-stratified Approach to Implementing Population-based Prostate Cancer Screening in Five Pilot Sites in the...

Area of Science:

• Urology
• Public Health
• Oncology

Background:

• Prostate cancer (PCa) is a leading cancer diagnosis in European men, with current screening methods facing challenges of overdiagnosis and overtreatment.
• The European Commission has proposed organized prostate-specific antigen (PSA) testing combined with magnetic resonance imaging (MRI) to mitigate these risks.

Purpose of the Study:

• To evaluate the feasibility, efficacy, and cost-effectiveness of a risk-stratified, population-based PCa screening approach.
• To gather data on clinical outcomes, psychosocial impact, and cost-effectiveness of the PRAISE-U pilot study.

Main Methods:

• A pilot study involving men aged 50-69 years in Ireland, Lithuania, Poland, and Spain.
• Participants undergo PSA testing; elevated PSA levels (>3 ng/ml) trigger risk stratification, followed by MRI and potentially biopsy.
• A collaborative user board and key performance indicators (KPIs) will guide the evaluation.

Main Results:

• The study is designed to collect pseudoanonymised data via a REDCap database.
• Pilot implementation is scheduled for Q3 2024 for 12 months.
• Expected to yield data on implementation outcomes of risk-stratified screening across Europe.

Conclusions:

• Findings will inform the development of an optimized PCa screening strategy.
• The goal is to achieve an acceptable benefit-to-harm ratio for population-based screening.
• This approach aims to balance early detection benefits with reduced risks of overdiagnosis and overtreatment.