Smarter screening for prostate cancer

Guan Hee Tan, Gregory Nason, Khaled Ajib, Dixon Teck Sing Woon, Jaime Herrera-Caceres, Omar Alhunaidi, Nathan Perlis

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

PURPOSE: Prostate cancer is the second commonest cancer among men. In the large European Randomized Study of Screening for Prostate Cancer (ERSPC) trial, prostate-specific antigen (PSA) screening has been shown to substantially reduce prostate cancer mortality. However, PSA screening is known to lead to more unnecessary prostate biopsies and over-diagnosis of clinically insignificant cancer. Therefore, it is imperative that smarter screening methods be developed to overcome the weaknesses of PSA screening. This review explores the novel screening tools that are available. METHODS: A comprehensive literature search was performed using PubMed regarding newer biomarkers, imaging techniques and risk-predicting models that are used to screen for prostate cancer in mainly biopsy-naïve men. RESULTS: Novel serum-based models like 4Kscore® and prostate health index (PHI) are generally better than PSA alone in detecting clinically significant cancer. Similarly, urine-based biomarkers like prostate cancer antigen 3 (PCA3) and HOXC6/DLX1 have been shown to be more accurate than PSA screening. More recently, multiparametric magnetic resonance imaging (mpMRI) is gaining popularity for its ability to detect clinically significant cancer. There is also evidence that combining individual tests to develop prediction models can reliably predict high-risk prostate cancers while reducing the number of unnecessary biopsies. Combinations such as the Stockholm-3 model (STHLM3) and other novel combinations are presented in this review. CONCLUSION: While we continue to find the smarter screening methods that are reliable, precise, and cost-effective, we continue to advocate shared decision-making in prostate cancer screening in order to work in our patients' best interests.

Original languageEnglish
Pages (from-to)991-999
Number of pages9
JournalWorld journal of urology
Volume37
Issue number6
DOIs
Publication statusPublished - 1 Jun 2019
Externally publishedYes

Fingerprint

Prostatic Neoplasms
Prostate-Specific Antigen
Biopsy
Prostate
Biomarkers
Neoplasms
Aptitude
Second Primary Neoplasms
Early Detection of Cancer
PubMed
Decision Making
Magnetic Resonance Imaging
Urine
Antigens
Costs and Cost Analysis
Mortality
Health
Serum

Keywords

  • mpMRI
  • Prostate cancer
  • Screening
  • Serum biomarker
  • Urine biomarker

ASJC Scopus subject areas

  • Urology

Cite this

Tan, G. H., Nason, G., Ajib, K., Woon, D. T. S., Herrera-Caceres, J., Alhunaidi, O., & Perlis, N. (2019). Smarter screening for prostate cancer. World journal of urology, 37(6), 991-999. https://doi.org/10.1007/s00345-019-02719-5

Smarter screening for prostate cancer. / Tan, Guan Hee; Nason, Gregory; Ajib, Khaled; Woon, Dixon Teck Sing; Herrera-Caceres, Jaime; Alhunaidi, Omar; Perlis, Nathan.

In: World journal of urology, Vol. 37, No. 6, 01.06.2019, p. 991-999.

Research output: Contribution to journalArticle

Tan, GH, Nason, G, Ajib, K, Woon, DTS, Herrera-Caceres, J, Alhunaidi, O & Perlis, N 2019, 'Smarter screening for prostate cancer', World journal of urology, vol. 37, no. 6, pp. 991-999. https://doi.org/10.1007/s00345-019-02719-5
Tan GH, Nason G, Ajib K, Woon DTS, Herrera-Caceres J, Alhunaidi O et al. Smarter screening for prostate cancer. World journal of urology. 2019 Jun 1;37(6):991-999. https://doi.org/10.1007/s00345-019-02719-5
Tan, Guan Hee ; Nason, Gregory ; Ajib, Khaled ; Woon, Dixon Teck Sing ; Herrera-Caceres, Jaime ; Alhunaidi, Omar ; Perlis, Nathan. / Smarter screening for prostate cancer. In: World journal of urology. 2019 ; Vol. 37, No. 6. pp. 991-999.
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