0
0
A groundbreaking three-step prostate cancer screening method has shown promising results in a large randomized trial conducted by researchers at Tampere University and the University of Helsinki. The ProScreen trial, coordinated by these institutions, aimed to evaluate the effectiveness of a novel screening approach in detecting aggressive prostate cancers while minimizing the overdiagnosis of insignificant cases.
Prostate cancer screening has been a subject of debate due to concerns about overdiagnosis and the potential harm caused by unnecessary treatments. Many prostate cancers are clinically insignificant and do not pose a significant threat to health if left untreated. Therefore, the challenge lies in identifying aggressive cancers that require intervention while avoiding unnecessary diagnoses.
The new screening method employed in the ProScreen study involves two blood tests followed by magnetic resonance imaging (MRI) of the prostate if necessary. Unlike previous methods that relied solely on the prostate-specific antigen test (PSA), this approach aims to improve accuracy and reduce the detection of clinically insignificant cancers.
In the trial, approximately 7% of participants had positive results in both blood tests and underwent MRI scans. Suspicious areas detected on MRI prompted further investigation with prostate biopsies. Ultimately, cancer was found in about 2% of participants, with clinically insignificant cases diagnosed in only four in a thousand men.
Professor Anssi Auvinen from Tampere University emphasizes the importance of balancing the benefits and harms of prostate cancer screening. While PSA screening has shown some efficacy in reducing mortality, the risks associated with overdiagnosis outweigh the benefits. The new three-step method appears to offer a more precise approach, leading to fewer unnecessary cancer diagnoses.
Co-lead investigator Professor Antti Rannikko from the University of Helsinki highlights the significance of avoiding the diagnosis of clinically insignificant cancers, which may lead to unnecessary treatments and associated side effects such as erectile dysfunction and urinary incontinence.
The study, which included over 60,000 men aged 50 to 63, is ongoing, with plans to expand the screening population and conduct follow-up assessments. The researchers stress the importance of analyzing long-term outcomes, particularly the effects on prostate cancer mortality.
While population-level screening programs for prostate cancer are not yet widespread, the ProScreen study aims to provide robust evidence to inform future screening decisions. With support from various funding sources and collaboration with multidisciplinary teams, including radiologists, pathologists, and urologists, the study represents a significant step forward in prostate cancer research.
Published in the Journal of the American Medical Association, the findings offer hope for improving prostate cancer screening and reducing the burden of unnecessary diagnoses and treatments in the future.
