Summary statement on screening for prostate cancer in Europe

The European Randomised Study of Screening for Prostate Cancer (ERSPC) showed that Prostate‐Specific Antigen (PSA) based screening results in a significant prostate cancer mortality reduction. Although there are concerns on overdiagnosis and overtreatment, it has been shown that the benefits can outweigh the harms if screening is stopped in older ages to prevent overdiagnosis. A limited screening program (for example screening at ages 55–59 years), including active surveillance for men with low‐risk tumors, can even be cost‐saving, compared with testing in an opportunistic setting in the wrong ages, as currently in Europe. Further improvements are expected in the use of active surveillance and in discrimination between indolent and significant disease due to new biomarkers and magnetic resonance imaging. However, these future developments are no reason to postpone feasibility studies of high‐quality PSA screening and reduce opportunistic testing at old ages.

[1]  E. Schaeffer,et al.  Active Surveillance for Prostate Cancer. , 2017, JAMA.

[2]  P. Stattin,et al.  Uptake of Active Surveillance for Very-Low-Risk Prostate Cancer in Sweden , 2017, JAMA oncology.

[3]  David Gillatt,et al.  10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. , 2017, The New England journal of medicine.

[4]  J. Gohagan,et al.  Extended mortality results for prostate cancer screening in the PLCO trial with median follow‐up of 15 years , 2017, Cancer.

[5]  A Hayen,et al.  The Diagnostic Performance of Multiparametric Magnetic Resonance Imaging to Detect Significant Prostate Cancer. , 2016, The Journal of urology.

[6]  P. Carroll,et al.  Active surveillance for prostate cancer: a narrative review of clinical guidelines , 2016, Nature Reviews Urology.

[7]  Martin Eklund,et al.  Prostate cancer screening in men aged 50-69 years (STHLM3): a prospective population-based diagnostic study. , 2015, The Lancet. Oncology.

[8]  J. Fütterer,et al.  Can Clinically Significant Prostate Cancer Be Detected with Multiparametric Magnetic Resonance Imaging? A Systematic Review of the Literature. , 2015, European urology.

[9]  M. Cooperberg,et al.  Long-term health-related quality of life after primary treatment for localized prostate cancer: results from the CaPSURE registry. , 2015, European urology.

[10]  John W. Scott,et al.  A multi-institutional prospective trial in the USA confirms that the 4Kscore accurately identifies men with high-grade prostate cancer. , 2015, European urology.

[11]  H. Brenner,et al.  Cancer surveillance using registry data: Results and recommendations for the Lithuanian national prostate cancer early detection programme. , 2015, European journal of cancer.

[12]  M. Cooperberg,et al.  Trends in Management for Patients With Localized Prostate Cancer, 1990-2013. , 2015, JAMA.

[13]  S. Taneja,et al.  Re: Cost-Effectiveness of Prostate Cancer Screening: A Simulation Study Based on ERSPC Data. , 2015, The Journal of urology.

[14]  S. Eggener,et al.  National Prostate Cancer Screening Rates After the 2012 US Preventive Services Task Force Recommendation Discouraging Prostate-Specific Antigen-Based Screening. , 2015, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[15]  John T. Wei,et al.  The prostate health index selectively identifies clinically significant prostate cancer. , 2015, The Journal of urology.

[16]  H. D. de Koning,et al.  Screening for prostate cancer in the US? Reduce the harms and keep the benefit , 2015, International journal of cancer.

[17]  C. Mathers,et al.  Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012 , 2015, International journal of cancer.

[18]  Ruth Etzioni,et al.  Is prostate cancer screening cost‐effective? A microsimulation model of prostate‐specific antigen‐based screening for British Columbia, Canada , 2014, International journal of cancer.

[19]  Mohammad Hassan Murad,et al.  Early detection of prostate cancer: AUA Guideline. , 2013, The Journal of urology.

[20]  M. Stockler,et al.  Risk assessment to guide prostate cancer screening decisions: a cost‐effectiveness analysis , 2013, The Medical journal of Australia.

[21]  P. Scardino,et al.  Strategy for detection of prostate cancer based on relation between prostate specific antigen at age 40-55 and long term risk of metastasis: case-control study , 2013, BMJ : British Medical Journal.

[22]  E. Steyerberg,et al.  A Calculator for Prostate Cancer Risk 4 Years After an Initially Negative Screen: Findings from ERSPC Rotterdam. , 2013, European urology.

[23]  Tobias Nordström,et al.  Prostate-specific antigen (PSA) testing is prevalent and increasing in Stockholm County, Sweden, Despite no recommendations for PSA screening: results from a population-based study, 2003-2011. , 2013, European urology.

[24]  Ruth Etzioni,et al.  Comparative Effectiveness of Alternative Prostate-Specific Antigen–Based Prostate Cancer Screening Strategies , 2013, Annals of Internal Medicine.

[25]  H. D. de Koning,et al.  Quality-of-life effects of prostate-specific antigen screening. , 2012, The New England journal of medicine.

[26]  H. Sox Quality of life and guidelines for PSA screening. , 2012, The New England journal of medicine.

[27]  M. Roobol,et al.  Infectious complications and hospital admissions after prostate biopsy in a European randomized trial. , 2012, European urology.

[28]  Ruth Etzioni,et al.  The impact of PLCO control arm contamination on perceived PSA screening efficacy , 2012, Cancer Causes & Control.

[29]  D. Easton,et al.  Polygenic susceptibility to prostate and breast cancer: implications for personalised screening , 2011, British Journal of Cancer.

[30]  J. Hugosson,et al.  The excess burden of side-effects from treatment in men allocated to screening for prostate cancer. The Göteborg randomised population-based prostate cancer screening trial. , 2011, European journal of cancer.

[31]  G. Andriole,et al.  Cost-effectiveness of prostate specific antigen screening in the United States: extrapolating from the European study of screening for prostate cancer. , 2011, The Journal of urology.

[32]  T. Wilt,et al.  Screening for prostate cancer: an updated Cochrane systematic review , 2011, BJU international.

[33]  F. Hamdy,et al.  Latest results from the UK trials evaluating prostate cancer screening and treatment: the CAP and ProtecT studies. , 2010, European journal of cancer.

[34]  P. Scardino,et al.  Prostate specific antigen concentration at age 60 and death or metastasis from prostate cancer: case-control study , 2010, BMJ : British Medical Journal.

[35]  David Chia,et al.  Mortality results from a randomized prostate-cancer screening trial. , 2009, The New England journal of medicine.

[36]  Angela Mariotto,et al.  Lead time and overdiagnosis in prostate-specific antigen screening: importance of methods and context. , 2009, Journal of the National Cancer Institute.

[37]  M. Roobol,et al.  A COMMENT ON PROSTATE CANCER SCREENING IN THE PROSTATE, LUNG, COLORECTAL AND OVARIAN CANCER SCREENING TRIAL: UPDATE ON FINDINGS FROM THE INITIAL FOUR ROUNDS OF SCREENING IN A RANDOMIZED TRIAL , 2009, BJU international.

[38]  J. Gohagan,et al.  Prostate cancer screening in the Prostate, Lung, Colorectal and Ovarian cancer screening trial: update on findings from the initial four rounds of screening in a randomized trial , 2008, BJU international.

[39]  Wadih Arap,et al.  Quality of life and satisfaction with outcome among prostate-cancer survivors. , 2008, The New England journal of medicine.

[40]  J. Habbema,et al.  Five‐year follow‐up of health‐related quality of life after primary treatment of localized prostate cancer , 2005, International journal of cancer.

[41]  M. Roobol,et al.  Is additional testing necessary in men with prostate-specific antigen levels of 1.0 ng/mL or less in a population-based screening setting? (ERSPC, section Rotterdam). , 2005, Urology.

[42]  Harry J de Koning,et al.  Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. , 2003, Journal of the National Cancer Institute.

[43]  F. Hamdy,et al.  Screening for Prostate Cancer , 2006 .

[44]  A. Auvinen,et al.  Cost-effectiveness of prostate cancer screening: a simulation study based on ERSPC data. , 2015, Journal of the National Cancer Institute.

[45]  D. Parekh,et al.  The 4Kscore® Test Reduces Prostate Biopsy Rates in Community and Academic Urology Practices. , 2015, Reviews in urology.

[46]  Ali Amin Al Olama,et al.  The genetic epidemiology of prostate cancer and its clinical implications , 2014, Nature Reviews Urology.

[47]  T. Tammela,et al.  Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up , 2014, The Lancet.

[48]  G. Andriole Long-Term Functional Outcomes after Treatment for Localized Prostate Cancer , 2013 .

[49]  Monique J. Roobol,et al.  Mortality Results from a Randomized ProstateCancer Screening Trial , 2009 .

[50]  B. G. Blijenberg,et al.  Screening and prostate-cancer mortality in a randomized European study. , 2009, The New England journal of medicine.

[51]  H. D. de Koning,et al.  Prostate cancer diagnosis: the impact on patients' mental health. , 2006, European journal of cancer.

[52]  Yair Lotan,et al.  Systematic review of complications of prostate biopsy. , 2013, European urology.