Screening for prostate cancer : evidence, ongoing trials, policies and knowledge gaps
Bratt, Ola LU ; Auvinen, Anssi ; Arnsrud Godtman, Rebecka ; Hellström, Mikael ; Hugosson, Jonas ; Lilja, Hans LU
; Wallström, Jonas
and Roobol, Monique J.
(2023)
In BMJ Oncology
2(1).
p.1-13
- Abstract
Long-term screening with serum prostate-specific antigen (PSA) and systematic prostate biopsies can reduce prostate cancer mortality but leads to unacceptable overdiagnosis. Over the past decade, diagnostic methods have improved and the indolent nature of low-grade prostate cancer has been established. These advances now enable more selective detection of potentially lethal prostate cancer. This non-systematic review summarises relevant diagnostic advances, previous and ongoing screening trials, healthcare policies and important remaining knowledge gaps. Evidence synthesis and conclusions: The strong association between low serum PSA values and minimal long-term risk of prostate cancer death allows for adjusting screening intervals. Use... (More)
Long-term screening with serum prostate-specific antigen (PSA) and systematic prostate biopsies can reduce prostate cancer mortality but leads to unacceptable overdiagnosis. Over the past decade, diagnostic methods have improved and the indolent nature of low-grade prostate cancer has been established. These advances now enable more selective detection of potentially lethal prostate cancer. This non-systematic review summarises relevant diagnostic advances, previous and ongoing screening trials, healthcare policies and important remaining knowledge gaps. Evidence synthesis and conclusions: The strong association between low serum PSA values and minimal long-term risk of prostate cancer death allows for adjusting screening intervals. Use of risk calculators, biomarkers and MRI to select men with a raised PSA value for biopsy and lesion-targeting rather than systematic prostate biopsies reduce the detection of low-grade cancer and thereby overdiagnosis. These improvements recently led the European Union to recommend its member states to evaluate the feasibility and effectiveness of organised screening programmes for prostate cancer. Nonetheless, important knowledge gaps remain such as the performance of modern diagnostic methods in long-term screening programmes and their impact on mortality. The knowledge gaps are currently being addressed in three large randomised screening trials. Population-based pilot programmes will contribute critical practical experience.
(Less)
- author
- Bratt, Ola
LU
; Auvinen, Anssi
; Arnsrud Godtman, Rebecka
; Hellström, Mikael
; Hugosson, Jonas
; Lilja, Hans
LU
; Wallström, Jonas
and Roobol, Monique J.
- organization
- publishing date
- 2023-04-20
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cancer screening, Prostate cancer
- in
- BMJ Oncology
- volume
- 2
- issue
- 1
- article number
- e000039
- pages
- 1 - 13
- external identifiers
-
- scopus:85170628153
- DOI
- 10.1136/bmjonc-2023-000039
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © Author(s) (or their employer(s)) 2024.
- id
- a2d31ca0-6944-4ed1-95dd-fb4c2f26db30
- date added to LUP
- 2024-06-23 12:41:22
- date last changed
- 2024-06-24 12:36:48
@article{a2d31ca0-6944-4ed1-95dd-fb4c2f26db30,
abstract = {{<p>Long-term screening with serum prostate-specific antigen (PSA) and systematic prostate biopsies can reduce prostate cancer mortality but leads to unacceptable overdiagnosis. Over the past decade, diagnostic methods have improved and the indolent nature of low-grade prostate cancer has been established. These advances now enable more selective detection of potentially lethal prostate cancer. This non-systematic review summarises relevant diagnostic advances, previous and ongoing screening trials, healthcare policies and important remaining knowledge gaps. Evidence synthesis and conclusions: The strong association between low serum PSA values and minimal long-term risk of prostate cancer death allows for adjusting screening intervals. Use of risk calculators, biomarkers and MRI to select men with a raised PSA value for biopsy and lesion-targeting rather than systematic prostate biopsies reduce the detection of low-grade cancer and thereby overdiagnosis. These improvements recently led the European Union to recommend its member states to evaluate the feasibility and effectiveness of organised screening programmes for prostate cancer. Nonetheless, important knowledge gaps remain such as the performance of modern diagnostic methods in long-term screening programmes and their impact on mortality. The knowledge gaps are currently being addressed in three large randomised screening trials. Population-based pilot programmes will contribute critical practical experience.</p>}},
author = {{Bratt, Ola and Auvinen, Anssi and Arnsrud Godtman, Rebecka and Hellström, Mikael and Hugosson, Jonas and Lilja, Hans and Wallström, Jonas and Roobol, Monique J.}},
keywords = {{Cancer screening; Prostate cancer}},
language = {{eng}},
month = {{04}},
number = {{1}},
pages = {{1--13}},
series = {{BMJ Oncology}},
title = {{Screening for prostate cancer : evidence, ongoing trials, policies and knowledge gaps}},
url = {{http://dx.doi.org/10.1136/bmjonc-2023-000039}},
doi = {{10.1136/bmjonc-2023-000039}},
volume = {{2}},
year = {{2023}},
}