Conceitos essenciais
A new three-phase screening protocol incorporating PSA test, four-kallikrein panel, and MRI scan can improve prostate cancer detection rates compared to no screening.
Resumo
The study presents preliminary findings from the Finnish ProScreen randomized clinical trial, which assessed a three-phase screening protocol for prostate cancer detection. The protocol involves:
- Initial PSA test
- Four-kallikrein panel for those with PSA ≥ 3.0 ng/mL to identify high-grade prostate cancer
- MRI scan for those with a high kallikrein panel risk score (≥ 7.5%), followed by targeted biopsies
The study randomized 60,745 men aged 50-63 years, with 15,201 invited to the screening protocol and 45,544 in the control group.
Among the 7,744 men who agreed to screening (51% of the invited group):
- 209 (2.7%) underwent targeted biopsies
- 136 biopsies (65%) detected cancer, including 32 low-grade and 128 high-grade prostate cancers
Compared to the control group, the screening protocol led to the detection of:
- 1 additional low-grade prostate cancer per 909 men invited
- 1 additional high-grade prostate cancer per 196 men invited
The authors note these results are descriptive and should be interpreted provisionally, pending the trial's primary outcomes on prostate cancer mortality.
Estatísticas
Among the 7,744 men who agreed to screening, 209 (2.7%) underwent targeted biopsies, and 136 biopsies (65%) detected cancer.
Compared to the control group, the screening protocol led to the detection of 1 additional low-grade prostate cancer per 909 men invited and 1 additional high-grade prostate cancer per 196 men invited.
Citações
"Among the 7744 invited men who agreed to the three-phase screening protocol (51%), ultimately 209 (2.7% of all screened participants) had a targeted transrectal prostate biopsy. Overall, 136 of the biopsies (65%) detected cancer — 32 low-grade and 128 high-grade prostate cancers, for cumulative incidence rates of 0.41% and 1.65%, respectively."
"Compared with the control group, the intervention led to the detection of one additional low-grade prostate cancer per 909 men invited to screen and one additional high-grade prostate cancer per 196 men invited."