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The Utility of Contemporary Community-Based Prostate Cancer Screening Campaigns.

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Community prostate cancer (PCa) screening campaigns effectively identify clinically significant PCa. Combining PSA testing, DRE, and MRI aids early detection, with a number needed to screen of 21 for significant disease.

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Area of Science:

  • Urology
  • Oncology
  • Public Health

Background:

  • Early detection of prostate cancer (PCa) may reduce mortality but risks overdiagnosis and overtreatment of indolent disease.
  • Evaluating community-based PCa early detection campaigns is crucial for optimizing screening strategies.
  • Assessing the yield of contemporary screening methods in a real-world setting is important.

Purpose of the Study:

  • To evaluate the effectiveness of community-based prostate cancer early detection campaigns.
  • To assess the diagnostic yield of combined PSA testing, digital rectal examination (DRE), and multiparametric MRI (mpMRI).
  • To identify factors associated with the diagnosis of clinically significant PCa (csPCa).

Main Methods:

  • Retrospective review of 19 PCa early detection campaigns (2015-2023).
  • Included PSA testing and DRE for all participants, with mpMRI for at-risk individuals.
  • Logistic regression analysis to determine factors associated with PCa diagnosis.

Main Results:

  • 1171 men screened; 7.4% underwent biopsy, with 76% diagnosed with PCa (86% csPCa).
  • Higher PSA levels and suspicious DRE findings were significantly associated with csPCa diagnosis.
  • Number needed to screen to diagnose 1 csPCa was 21 (95% CI 16-27).

Conclusions:

  • Contemporary PCa screening campaigns combining PSA, DRE, and MRI can effectively detect csPCa.
  • Judicious use of prostate MRI and biopsy enhances the diagnostic accuracy of screening programs.
  • These campaigns demonstrate a favorable balance between early detection and avoiding overdiagnosis.