Structured Population-based Prostate-specific Antigen Screening for Prostate Cancer: The European Association of Urology Position in 2019

Publication date: Available online 12 May 2019Source: European UrologyAuthor(s): Giorgio Gandaglia, Peter Albers, Per-Anders Abrahamsson, Alberto Briganti, James W.F. Catto, Christopher R. Chapple, Francesco Montorsi, Nicolas Mottet, Monique J. Roobol, Jens Sønksen, Manfred Wirth, Hendrik van PoppelAbstractProstate cancer (PCa) is one of the first three causes of cancer mortality in Europe. Screening in asymptomatic men (aged 55–69 yr) using prostate-specific antigen (PSA) is associated with a migration toward lower staged disease and a reduction in cancer-specific mortality. By 20 yr after testing, around 100 men need to be screened to prevent one PCa death. While this ratio is smaller than for breast and colon cancer, the long natural history of PCa means many men die from other causes. As such, the nonselective use of PSA testing and radical treatments can lead to overdiagnosis and overtreatment. The European Association of Urology (EAU) supports measures to encourage appropriate PCa detection through PSA testing, while reducing overdiagnosis and overtreatment. These goals may be achieved using personalized risk-stratified approaches. For diagnosis, the greatest benefit from early detection is likely to come in men assessed using baseline PSA levels at the age of 45 yr to individualize screening intervals. Multiparametric magnetic resonance imaging as well as risk calculators based on family history, ethnicity, digital rectal examination, and prostate vol...
Source: European Urology - Category: Urology & Nephrology Source Type: research