23 The German risk-adapted PCA Screening Trial (PROBASE) – first results

Arsov, Christian; Becker, Nancy; Herkommer, Kathleen; Gschwend, Jürgen E.; Imkamp, Florian; Kuczyk, M.; Hadaschik, Boris; Hohenfellner, M.; Siener, Roswitha; Kristiansen, G.; Antoch, Gerald; Albers, Peter

doi:10.1016/s1569-9056(15)60026-4

Cited by 1 publication

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“…114 The first results of this trial show that only 14% complied with the invitation and of the men randomized to immediate screening, only 1.8% showed a PSA ≥3.0 ng/mL, of which 43% based on a confirmatory second PSA test had a PSA ≥3.0 ng/mL. 115 Updated results of this trial show similar results; 1.5% of men randomized to immediate screening showed PSA ≥3.0 ng/mL, of which 53% is confirmed at repeat PSA testing. 116 Of the men with confirmed PSA ≥3.0 ng/mL, 33% of men were diagnosed with PCa, of which 68% was csPCa.…”

Section: Which Men Are Most Likely To Benefit From Screeningmentioning

confidence: 99%

“…The Prostate Early Detection Study Based on a “Baseline” PSA Value in Young Men (PROBASE) trial randomized 50 000 men aged 45 at an immediate screening arm or a delayed screening arm at age 50 with screening intervals based on their “baseline” PSA level 114 . The first results of this trial show that only 14% complied with the invitation and of the men randomized to immediate screening, only 1.8% showed a PSA ≥3.0 ng/mL, of which 43% based on a confirmatory second PSA test had a PSA ≥3.0 ng/mL 115 . Updated results of this trial show similar results; 1.5% of men randomized to immediate screening showed PSA ≥3.0 ng/mL, of which 53% is confirmed at repeat PSA testing 116 .…”

Section: How Should We Screen To Keep the Benefit And Reduce The Harmmentioning

confidence: 99%

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Personalized strategies in population screening for prostate cancer

Remmers

Roobol

2020

Intl Journal of Cancer

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This review discusses evidence for population-based screening with contemporary screening tools. In Europe, prostate-specific antigen (PSA)-based screening led to a relative reduction of prostate cancer (PCa) mortality, but also to a substantial amount of overdiagnosis and unnecessarily biopsies. Risk stratification based on a single variable (a clinical variable or based on the presence of a lesion on prostate imaging) or based on multivariable approaches can aid in reducing unnecessary prostate biopsies and overdiagnosis by selecting men who can benefit from further clinical assessment. Multivariable approaches include clinical variables, and biomarkers, often combined in risk calculators or nomograms. These risk calculators can also incorporate the result of MRI imaging. In general, as compared to a purely PSA based approach, the combination of relevant prebiopsy information results in superior selection of men at higher risk of harboring clinically significant prostate cancer. Currently, it is not possible to draw any conclusions on the superiority of these multivariable risk-based approaches since head-to-head comparisons are virtually lacking. Recently initiated large population-based screening studies in Finland, Germany and Sweden, incorporating various multivariable risk stratification approaches will hopefully give more insight in whether the harm-benefit ratio can be improved, that is, maintain (or improving) the ability to reduce metastatic disease and prostate cancer mortality while reducing harm caused by unnecessary testing and overdiagnosis including related overtreatment.

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Section: Which Men Are Most Likely To Benefit From Screeningmentioning

confidence: 99%