Evolution of Prostate Cancer Screening Protocols in Europe

What is it about?

This article discusses the improvements that have been made in the early detection, diagnosis, and treatment of prostate cancer over the past three decades. These improvements include better identification of individuals at risk, individualized re-testing intervals, optimised and individualized starting and stopping age, improved risk stratification for biopsy, targeted biopsy, transperineal biopsy approach, active surveillance for low-risk prostate cancer, and improved staging of disease. The article concludes that these improvements can help reduce the side-effects of screening while maintaining the advantages, and that future developments include dynamic and individualized risk indication and follow-up, individualized biopsy decisions and strategies, and wider indication for expectant management.

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Why is it important?

This research is important because it summarizes the most important potential improvements in the early detection cascade of screening, diagnosis, and treatment for prostate cancer that have been introduced over the past three decades. By incorporating these improvements in a modern screening protocol, it is expected to retain or even improve the advantages of screening for prostate cancer while reducing side-effects, mainly overdiagnosis with the risk of overtreatment. The knowledge gained and new developments on early detection are being tested in different prospective screening trials throughout Europe, and the European Union-funded PRostate cancer Awareness and Initiative for Screening in the European Union (PRAISE-U) project will compare and evaluate different screening pilots throughout Europe. Key Takeaways: 1. Modern screening approaches may reduce the burden of the second most frequent cause of cancer-related death in European males, while minimising side-effects. 2. Less efficacious opportunistic early detection may be indirectly reduced. 3. Incorporating improvements in a modern screening protocol may retain or even improve the advantages of screening for prostate cancer while reducing side-effects. 4. Prospective screening trials and the PRAISE-U project are testing the impact of modern screening approaches on early detection, diagnosis, and treatment of prostate cancer.