R Al-Monajjed1, C Arsov2, P Albers2. 1. Medizinische Fakultät, Universitätsklinikum Düsseldorf, Klinik für Urologie, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland. Rouvier.Al-Monajjed@med.uni-duesseldorf.de. 2. Medizinische Fakultät, Universitätsklinikum Düsseldorf, Klinik für Urologie, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
Abstract
BACKGROUND:Prostate cancer (PCa) is the most common cancer and the second leading cause of cancer death in men in industrialized countries. There is no commonly accepted prostate cancer screening strategy. Based on the experience of various international screening studies, the German Prostate Cancer Early Detection Study Based on a Baseline PSA Value in Young Men (PROBASE) was established in 2014. OBJECTIVE: Based on the positive results of retrospective cohort analyses, the PROBASE study is designed to demonstrate that a screening strategy based on risk stratification by a baseline prostate-specific antigen (PSA) level at age 45 or 50 years may be an alternative to population-based screening. PROBASE is presented in the context of other risk-adapted screening studies. MATERIALS AND METHODS: There are basically several approaches to improve the population-based screening of PCa. Known risk factors for prostate cancer are age, a certain genetic predisposition (BRCA 1/2) and other germline mutations as well as individual somatic mutations. RESULTS:A total of 23,301 participants were randomized to study arm A. Baseline PSA testing in study arm A categorized 89.18% of participants into the low-risk group, 9.32% into the intermediate-risk group, and 1.48% into the high-risk group. Thus, the risk assignment exactly matched the previously reported distribution. DISCUSSION: Baseline PSA-dependent, risk-adapted PSA screening has the potential to reduce the high incidence of overdiagnosis and ultimately overtreatment of insignificant prostate cancers of population-based screening through extended testing intervals in the low-risk group. In parallel with PROBASE, several risk-adapted screening strategies are currently being tested worldwide; the evaluation of which is also awaited in several years.
RCT Entities:
BACKGROUND:Prostate cancer (PCa) is the most common cancer and the second leading cause of cancer death in men in industrialized countries. There is no commonly accepted prostate cancer screening strategy. Based on the experience of various international screening studies, the German Prostate Cancer Early Detection Study Based on a Baseline PSA Value in Young Men (PROBASE) was established in 2014. OBJECTIVE: Based on the positive results of retrospective cohort analyses, the PROBASE study is designed to demonstrate that a screening strategy based on risk stratification by a baseline prostate-specific antigen (PSA) level at age 45 or 50 years may be an alternative to population-based screening. PROBASE is presented in the context of other risk-adapted screening studies. MATERIALS AND METHODS: There are basically several approaches to improve the population-based screening of PCa. Known risk factors for prostate cancer are age, a certain genetic predisposition (BRCA 1/2) and other germline mutations as well as individual somatic mutations. RESULTS: A total of 23,301 participants were randomized to study arm A. Baseline PSA testing in study arm A categorized 89.18% of participants into the low-risk group, 9.32% into the intermediate-risk group, and 1.48% into the high-risk group. Thus, the risk assignment exactly matched the previously reported distribution. DISCUSSION: Baseline PSA-dependent, risk-adapted PSA screening has the potential to reduce the high incidence of overdiagnosis and ultimately overtreatment of insignificant prostate cancers of population-based screening through extended testing intervals in the low-risk group. In parallel with PROBASE, several risk-adapted screening strategies are currently being tested worldwide; the evaluation of which is also awaited in several years.
Entities:
Keywords:
Active Surveillance; BRCA; Neoplasm metastasis; Prostate-specific antigen; mpMRT
Authors: Jacob Fredsøe; Jan Koetsenruyter; Peter Vedsted; Pia Kirkegaard; Michael Væth; Adrian Edwards; Torben F Ørntoft; Karina D Sørensen; Flemming Bro Journal: PLoS Med Date: 2020-02-07 Impact factor: 11.069
Authors: David Eldred-Evans; Paula Burak; Martin J Connor; Emily Day; Martin Evans; Francesca Fiorentino; Martin Gammon; Feargus Hosking-Jervis; Natalia Klimowska-Nassar; William McGuire; Anwar R Padhani; A Toby Prevost; Derek Price; Heminder Sokhi; Henry Tam; Mathias Winkler; Hashim U Ahmed Journal: JAMA Oncol Date: 2021-03-01 Impact factor: 31.777