A randomized trial of risk-adapted screening for prostate cancer in young men-Results of the first screening round of the PROBASE trial.

Arsov, Christian; Albers, Peter; Herkommer, Kathleen; Gschwend, Jürgen; Imkamp, Florian; Peters, Inga; Kuczyk, Markus; Hadaschik, Boris; Kristiansen, Glen; Schimmöller, Lars; Antoch, Gerald; Rummeny, Ernst; Wacker, Frank; Schlemmer, Heinz; Benner, Axel; Siener, Roswitha; Kaaks, Rudolf; Becker, Nikolaus

doi:10.1002/ijc.33940

journal article

Title:: A randomized trial of risk-adapted screening for prostate cancer in young men-Results of the first screening round of the PROBASE trial.
Document type:: Journal Article
Author(s):: Arsov, Christian; Albers, Peter; Herkommer, Kathleen; Gschwend, Jürgen; Imkamp, Florian; Peters, Inga; Kuczyk, Markus; Hadaschik, Boris; Kristiansen, Glen; Schimmöller, Lars; Antoch, Gerald; Rummeny, Ernst; Wacker, Frank; Schlemmer, Heinz; Benner, Axel; Siener, Roswitha; Kaaks, Rudolf; Becker, Nikolaus
Abstract:: There is no generally accepted screening strategy for prostate cancer (PCa). From February 2014 to December 2019 a randomized trial (PROBASE) recruited 46 642 men at age 45 to determine the efficacy of risk-adapted prostate-specific antigen-based (PSA) screening, starting at either 45 or 50 years. PSA tests are used to classify participants into a low (<1.5 ng/mL), intermediate (1.5-2.99 ng/mL) or high (≥3 ng/mL) risk group. In cases of confirmed PSA values ≥3 ng/mL participants are recommended a prostate biopsy with multiparametric magnetic resonance imaging (mpMRI). Half of the participants (N = 23 341) were offered PSA screening immediately at age 45; the other half (N = 23 301) were offered digital rectal examination (DRE) with delayed PSA screening at age 50. Of 23 301 participants who accepted baseline PSA testing in the immediate screening arm, 89.2% fell into the low, 9.3% into intermediate, and 1.5% (N = 344) into the high risk group. Repeat PSA measurement confirmed high-risk status for 186 men (0.8%), of whom 120 (64.5%) underwent a biopsy. A total of 48 PCas was detected (overall prevalence 0.2%), of which 15 had International Society of Uropathology (ISUP) grade 1, 29 had ISUP 2 and only 4 had ISUP ≥3 cancers. In the delayed screening arm, 23 194 participants were enrolled and 6537 underwent a DRE with 57 suspicious findings, two of which showed PCa (both ISUP 1; detection rate 0.03%). In conclusion, the prevalence of screen-detected aggressive (ISUP ≥3) PCa in 45-year-old men is very low. DRE did not turn out effective for early detection of PCa.
Journal title abbreviation:: Int J Cancer
Year:: 2022
Journal volume:: 150
Journal issue:: 11
Pages contribution:: 1861-1869
Fulltext / DOI:: doi:10.1002/ijc.33940
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/35076933
Print-ISSN:: 0020-7136
TUM Institution:: 1145; Institut für Diagnostische und Interventionelle Radiologie ; Klinik und Poliklinik für Urologie
BibTeX