Summary statement on screening for prostate cancer in Europe

• Published in: International journal of cancer Vol. 142; no. 4; pp. 741 - 746
• Main Authors: Heijnsdijk, Eveline A.M., Bangma, Chris H., Borràs, Josep M., de Carvalho, Tiago M., Castells, Xavier, Eklund, Martin, Espinàs, Josep A., Graefen, Markus, Grönberg, Henrik, Lansdorp‐Vogelaar, Iris, Leeuwen, Pim J. van, Nelen, Vera, Recker, Franz, Roobol, Monique J., Vandenbulcke, Pieter, de Koning, Harry J.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 15.02.2018
• Subjects: Antigens; Cancer; Cancer screening; Feasibility studies; Magnetic resonance imaging; mass‐screening; Medical research; Medical screening; Medicin och hälsovetenskap; Mortality; Prostate cancer; Prostate-specific antigen; PSA; Surveillance; Tumors; mortality; prostate cancer; mass-screening; PSA
• ISSN: 0020-7136; 1097-0215; 1097-0215
• DOI: 10.1002/ijc.31102

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. What's new? This article is a summary of the European consensus meeting where more than 30 experts discussed the benefits, harms, and cost‐effectiveness of prostate cancer screening. The participants strongly agreed that Prostate‐Specific Antigen (PSA) screening can substantially reduce prostate cancer mortality. Concerns over overdiagnosis and overtreatment remained, however. The experts found that the benefits can outweigh the harms if screening is stopped in older ages. A limited screening program (in screens and age range), including active surveillance for men with low‐risk tumors, can even be cost‐saving. The experts recommend starting pilot studies for the implementation of limited, organised prostate cancer screening.