Prostate cancer screening - Knowledge (XXG)

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during their lifetime but screening may result in the overdiagnosis and overtreatment of prostate cancer. Though the death rates from prostate cancer continue to decline, 238,590 men were diagnosed with prostate cancer in the United States in 2013 while 29,720 died as a result. Death rates from prostate cancer have declined at a steady rate since 1992. Cancers of the prostate, lung and bronchus, and colorectum accounted for about 50% of all newly diagnosed cancers in American men in 2013, with prostate cancer constituting 28% of cases. Screening for prostate cancer varies by state and indicates differences in the use of screening for prostate cancer as well as variations between locales. Out of all cases of prostate cancer, African American men have an incidence of 62%. African American men are less likely to receive standard therapy for prostate cancer. This discrepancy may indicate that if they were to receive higher quality cancer treatment their survival rates would be similar to whites.

336:"recommends that asymptomatic men who have at least a 10-year life expectancy have an opportunity to make an informed decision with their health care provider about screening for prostate cancer after they receive information about the uncertainties, risks, and potential benefits associated with prostate cancer screening. Prostate cancer screening should not occur without an informed decision-making process. Men at average risk should receive this information beginning at age 50 years. Men in higher risk groups should receive this information before age 50 years. Men should either receive this information directly from their health care providers or be referred to reliable and culturally appropriate sources." 258:-PSMA PET/CT imaging has become, in a relatively short period of time, the gold standard for restaging recurrent prostate cancer in clinical centers in which this imaging modality is available. It is likely to become the standard imaging modality in the staging of intermediate-to-high risk primary prostate cancer. The potential to guide therapy, and to facilitate more accurate prostatic biopsy is being explored. In the theranostic paradigm, Ga-PSMA PET/CT imaging is critical for detecting prostate specific membrane antigen-avid disease which may then respond to targeted 247:

found to be cost-effective. MRI imaging can be used for patients who have had a previous negative biopsy but their PSA continues to increase. Consensus has not been determined as to which of the MRI-targeted biopsy techniques is more useful. In a study involving 400 men aged 50 – 69, MRI screening identified more men with prostate cancer than PSA tests or ultrasound and did not increase the number of men who needed a biopsy. A large-scale trial of MRI screening, TRANSFORM, began in the UK in spring 2024.

238:(TRUS) has the advantage of being fast and minimally invasive, and better than MRI for the evaluation of superficial tumor. It also gives details about the layers of the rectal wall, accurate and useful for staging primary rectal cancer. While MRI is better in visualization of locally advanced and stenosing cancers, for staging perirectal lymph nodes, both TRUS and MRI are capable. TRUS has a small field of view, but 3D TRUS can improve the diagnosis of anorectal diseases. 2254: 2189: 423: 110: 329:(USPSTF) recommended against prostate cancer screening using PSA. As of 2018 a draft for new recommendations suggests that screening be individualized for those between the ages of 55 to 69. It notes a small potential decrease in the risk of dying from prostate cancer, but harm from overtreatment. In those over the age of 70, PSA based screening is still recommended against. 266:-PSMA therapies. For local recurrence, Ga-PSMA PET/MR or PET/CT in combination with mpMR is most appropriate. PSMA PET/CT may be potentially helpful for locating the cancer when combined with multiparametric MRI (mpMRI) for primary prostate care. Prostate multiparametric MR imaging (mpMRI) is helpful in evaluating recurrence of primary prostate cancer following treatment. 567: 525: 399:, likewise acknowledge that "organizations vary in their recommendations about who should – and who shouldn't – get a PSA screening test. They conclude: "Ultimately, whether you should have a PSA test is something you'll have to decide after discussing it with your doctor, considering your risk factors and weighing your personal preferences." 151:(USPSTF) draft adjusted the prior opposition to PSA screening. It suggests shared decision-making regarding screening in healthy males 55 to 69 years of age. The final recommendation for that age group states screening should only be done in those who wish it. In those 70 and over, screening remains not recommended. 316:

machine learning algorithms, random forest and neural network. Both algorithms provided a monotonic increase in screening performance as the number of biomarkers was increased. With the best combination of biomarkers, the algorithms were able to screen prostate cancer patients with more than 99% accuracy.

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A study published in the European Journal of Cancer (October 2009) documented that prostate cancer screening reduced prostate cancer mortality by 37 percent. By utilizing a control group of men from Northern Ireland, where PSA screening is infrequent, the research showed this substantial reduction in

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Screening for prostate cancer continues to generate debate among clinicians and broader lay audiences. Publications authored by governmental, non-governmental and medical organizations continue the debate and publish recommendations for screening. One in six men will be diagnosed with prostate cancer

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MRI is used when screening suggests a malignancy. This model potentially minimizes unnecessary prostate biopsies while maximizing biopsy yield. Despite concerns about the cost of MRI scans, compared to the long-term cost burden of the PSA/TRUS biopsy-based standard of care, the imaging model has been

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The USPSTF recommends against digital rectal examination as a screening tool due to lack of evidence of benefits. Although DRE has long been used to diagnose prostate cancer, no controlled studies have shown a reduction in the morbidity or mortality of prostate cancer when detected by DRE at any age.

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they have high-grade (i.e., aggressive) prostate cancer. Conversely, some argue against PSA testing for men who are too young, because too many men would have to be screened to find one cancer, and too many men would have treatment for cancer that would not progress. Low-risk prostate cancer does not

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recommends screening be discouraged for those who are expected to live less than ten years, while for those with a longer life expectancy a decision should be made by the person in question. In general, they conclude that based on recent research, "it is uncertain whether the benefits associated with

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Prostate cancer is also extremely heterogeneous: most prostate cancers are indolent and would never progress to a clinically meaningful stage if left undiagnosed and untreated during a man's lifetime. On the other hand, a subset are potentially lethal, and screening can identify some of these within

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The American Urological Association in 2018 states that men under the age of 55 and over the age of 69 should not be routinely screened. The greatest benefit of screening appears to be in men ages 55 to 69 years. To reduce the harms of screening, a routine screening interval of two years or more may

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Screening of PSA began in the 1990s. In the European Randomized Study of Screening for Prostate Cancer (ERSPC) initiated in the early 1990s, the researchers concluded that PSA-based screening did reduce the rate of death from prostate cancer but created a high risk of overdiagnosis, i.e., 1410 men

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Researchers at the Korea Institute of Science and Technology (KIST) developed a urinary multi marker sensor with the ability to measure trace amounts of biomarkers from naturally voided urine. The correlation of clinical state with the sensing signals form urinary multi markers was analyzed by two

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The Canadian Urological Association in 2017 suggested screening be offered as a possibility to those who are expected to live more than 10 years, with the final decision based on shared decision making. They recommend a starting age for most people at 50, and age 45 among those at high risk. The

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One commentator observed in 2011: “t is prudent only to use a single PSA determination as a baseline, with biopsy and cancer treatment reserved for those with significant PSA changes over time, or for those with clinical manifestations mandating immediate therapy..... absolute levels of PSA are

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A study by Krilaviciute et al. (2023) examined the effectiveness of the DRE as a standalone screening test for prostate cancer in >46,000 young men in Germany (age 45). It was found that DRE has a much lower detection rate for prostate cancer compared to PSA screening. Therefore, the authors

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review concluded PSA screening results in "no statistically significant difference in prostate cancer-specific mortality...". The American studies were determined to have a high bias. European studies included in this review were of low bias and one reported "a significant reduction in prostate

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Wegelin O, van Melick HH, Hooft L, Bosch JL, Reitsma HB, Barentsz JO, et al. (April 2017). "Comparing Three Different Techniques for Magnetic Resonance Imaging-targeted Prostate Biopsies: A Systematic Review of In-bore versus Magnetic Resonance Imaging-transrectal Ultrasound fusion versus

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A 2009 study in Europe resulted in only a small decline in death rates and concluded that 48 men would need to be treated to save one life. But of the 47 men who were treated, most would be unable to ever again function sexually and would require more frequent trips to the bathroom. Aggressive

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Schoots IG, Roobol MJ, Nieboer D, Bangma CH, Steyerberg EW, Hunink MG (September 2015). "Magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: a systematic review and

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Catalona WJ, Richie JP, Ahmann FR, Hudson MA, Scardino PT, Flanigan RC, et al. (May 1994). "Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men".

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ConfirmMDx is performed on tissue taken during a prostate biopsy. The test identifies men with clinically significant prostate cancer who would benefit from further testing and treatment. It can also help men without significant prostate cancer avoid unnecessary repeat

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The American Urological Association in 2018 stated that for men aged 55 to 69, they could find no evidence to support the continued use of DRE as a first-line screening test; however, in men referred for an elevated PSA, DRE may be a useful secondary test.

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are used to diagnose prostate cancer but are not done on asymptomatic men and therefore are not used for screening. Infection after prostate biopsy occurs in about 1%, while death occurs as a result of biopsy in 0.2%. Prostate biopsy guided by

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in 2009 found that over a 7 to 10-year period, "screening did not reduce the death rate in men 55 and over." Former screening proponents, including some from Stanford University, have come out against routine testing. In February 2010, the

227:. The biopsy technique includes factors such as needle angle and prostate mapping method. Patients with localized cancer and perineural invasion may benefit more from immediate treatment rather than adopting a watchful waiting approach. 3357: 339:

Other guidelines and centers specializing in treating prostate cancer recommend obtaining a PSA in all men at age 45. This is based on emerging data indicating that an increased baseline PSA can be used to detect future significant

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and presses on the prostate, to check its size and to detect any lumps on the accessible side. If the examination suggests anomalies, a PSA test is performed. If an elevated PSA level is found, a follow-up test is then performed.

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practices with 460,000 men aged 50–69 at centers in 9 cities in Britain from 2001–2005 to usual care or prostate cancer screening with PSA (biopsy if PSA ≥ 3). The "Comparison Arm" has yet to report as of early 2018.

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always require immediate treatment, but may be amenable to active surveillance. A PSA test cannot 'prove' the existence of prostate cancer by itself; varying levels of the antigen can be due to other causes.

286:) associated with prostate cancer. Used in conjunction with a PSA test, the PSE test boosts accuracy from 55% to 94% offering a more effective and precise method for detecting and diagnosing prostate cancer. 218:

are considered the gold standard in detecting prostate cancer. Infection is a possible risk. MRI guided techniques have improved the diagnostic accuracy of the procedure. Biopsies can be done through the

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Kim H, Park S, Jeong IG, Song SH, Jeong Y, Kim CS, et al. (9 December 2020). "Noninvasive Precision Screening of Prostate Cancer by Urinary Multimarker Sensor and Artificial Intelligence Analysis".

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Canadian Task Force on Preventive Health Care in 2014 strongly recommended against screening in those under 55 and over 70 years of age. They weakly recommended against screening among those 55–69.

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Screening for prostate cancer is controversial because of cost and uncertain long-term benefits to patients. Horan echos that sentiment in his book. Private medical institutes, such as the

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with associated harms, increased anxiety, and unneeded treatment. The evidence surrounding prostate cancer screening indicates that it may cause little to no difference in mortality.

2974: 392:, potentially lethal prostate cancer, with the understanding that lower-risk disease, if discovered, often does not need treatment and may be amenable to active surveillance. 351:

did not offer general PSA screening, for similar reasons to those given above. Individuals over the age of 50 who request it can normally obtain testing covered by the NHS.

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EpiSwitch® PSE is a blood test used for screening and diagnosing prostate cancer utilizing epigenetic markers to identify specific changes in regulatory looping structures (

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Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, et al. (March 2009). "Screening and prostate-cancer mortality in a randomized European study".

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Men report low levels of distress surrounding PSA screening. Men who present for PSA or have PSA levels at baseline scored low on cancer distress on numerous scales.

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rarely meaningful; it is the relative change in PSA levels over time that provides insight, but not definitive proof of a cancerous condition necessitating therapy.“

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be preferred over annual screening in those men who have participated in shared decision-making and decided on screening. Screening is done by PSA (blood test).

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Greene KL, Albertsen PC, Babaian RJ, Carter HB, Gann PH, Han M, et al. (January 2013). "Prostate specific antigen best practice statement: 2009 update".

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would need to be screened and 48 additional cases of prostate cancer would need to be treated to prevent just one death from prostate cancer within 9 years.

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recommend not to use DRE as a screening test for prostate cancer in young men, as it does not provide an improvement in detection compared to PSA screening.

148: 65:(DRE) is one screening tool, during which the prostate is manually assessed through the wall of the rectum. The second screening tool is the measurement of 58:. When abnormal prostate tissue or cancer is found early, it may be easier to treat and cure, but it is unclear if early detection reduces mortality rates. 190:

A 2018 review recommended against primary care screening for prostate cancer with DRE due to the lack of evidence of the effectiveness of the practice.

2490:"Circulating Chromosome Conformation Signatures Significantly Enhance PSA Positive Predicting Value and Overall Accuracy for Prostate Cancer Detection" 1609: 3537: 960:

Bell N, Connor Gorber S, Shane A, Joffres M, Singh H, Dickinson J, et al. (Canadian Task Force on Preventive Health Care) (4 November 2014).

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Collins MM, Barry MJ (December 1996). "Controversies in prostate cancer screening. Analogies to the early lung cancer screening debate".

1088: 3709: 1568: 73:. The evidence remains insufficient to determine whether screening with PSA or DRE reduces mortality from prostate cancer. A 2013 3542: 3470: 459: 439: 404: 283: 90:

PSA testing for prostate cancer screening are worth the harms associated with screening and subsequent unnecessary treatment."

3775: 3770: 2032:"Population-Based Prostate Cancer Screening With Magnetic Resonance Imaging or Ultrasonography: The IP1-PROSTAGRAM Study" 300:(PHI) is a PSA-based blood test for early prostate cancer screening. It may be used to determine when a biopsy is needed. 2261: by Irene Virgolini, Clemens Decristoforo, Alexander Haug, Stefano Fanti, and Christian Uprimny available under the 141: 1685: 458:

Comparison Arm for ProtecT (CAP), as part of the Prostate testing for cancer and Treatment (ProtecT) study, randomized

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cancer-specific mortality." PSA screening with DRE was not assessed in this review. DRE was not assessed separately.

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marketing of screening tests by drug companies has also generated controversy as has the advocacy of testing by the

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Kretschmer A, Tilki D (2017). "Biomarkers in prostate cancer – Current clinical utility and future perspectives".

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Haythorn MR, Ablin RJ (August 2011). "Prostate-specific antigen testing across the spectrum of prostate cancer".

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Esserman L, Shieh Y, Thompson I (October 2009). "Rethinking screening for breast cancer and prostate cancer".

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Most recent guidelines have recommended that the decision whether or not to screen should be based on

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Harnden P, Shelley MD, Clements H, Coles B, Tyndale-Biscoe RS, Naylor B, et al. (January 2007).

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Stewart RW, Lizama S, Peairs K, Sateia HF, Choi Y (February 2017). "Screening for prostate cancer".

307:) is a urine test that detects the overexpression of the PCA3 gene, an indicator of prostate cancer. 3714: 388:

a window of opportunity for cure. Thus, PSA screening is advocated by some as a means of detecting

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or other prostate disorders. PSA is not a unique indicator of prostate cancer, but may also detect

2554:"Canadian Urological Association recommendations on prostate cancer screening and early diagnosis" 549: 3749: 3724: 3622: 3612: 3520: 3349: 3302: 3062: 3013: 2907: 2746: 2639: 1667: 1435: 937: 732: 220: 179: 3320:

van Leeuwen PJ, Connolly D, Gavin A, Roobol MJ, Black A, Bangma CH, et al. (January 2010).

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Chad-Friedman E, Coleman S, Traeger LN, Pirl WF, Goldman R, Atlas SJ, et al. (2017-10-15).

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Tseng CW, Siu AL, Simon MA, Silverstein M, Mangione CM, Landefeld CS, et al. (2018-05-08).

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Naji L, Randhawa H, Sohani Z, Dennis B, Lautenbach D, Kavanagh O, et al. (12 March 2018).

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On the other hand, up to 25% of men diagnosed in their 70s or even 80s die of prostate cancer,

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Wolf AM, Wender RC, Etzioni RB, Thompson IM, D'Amico AV, Volk RJ, et al. (Mar–Apr 2010).

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Pchejetski D, Hunter E, Dezfouli M, Salter M, Powell R, Green J, et al. (January 2023).

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Eldred-Evans D, Burak P, Connor MJ, Day E, Evans M, Fiorentino F, et al. (2021-03-01).

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Lu-Yao GL, Albertsen PC, Moore DF, Shih W, Lin Y, DiPaola RS, et al. (September 2009).

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prostate cancer deaths when compared to men who were PSA tested as part of the ERSPC study.

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for prostate cancer exist. These include the following blood, urine and tissue based tests:

3157: 2717:"American Cancer Society guideline for the early detection of prostate cancer: update 2010" 1521:"Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement" 750:

Basch E, Oliver TK, Vickers A, Thompson I, Kantoff P, Parnes H, et al. (August 2012).

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Borghesi M, Ahmed H, Nam R, Schaeffer E, Schiavina R, Taneja S, et al. (March 2017).

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gland and can be detected in a sample of blood. PSA is present in small quantities in the

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Loeb S, Vellekoop A, Ahmed HU, Catto J, Emberton M, Nam R, et al. (December 2013).

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Wolf AM, Wender RC, Etzioni RB, Thompson IM, D'Amico AV, Volk RJ, et al. (2010).

2658:"Final Update Summary: Prostate Cancer: Screening - US Preventive Services Task Force" 1638:

Krilaviciute A, Becker N, Lakes J, Radtke JP, Kuczyk M, Peters I, et al. (2023).

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Rendon RA, Mason RJ, Marzouk K, Finelli A, Saad F, So A, et al. (October 2017).

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Progensa PCA3 Assay . 502083-IFU-PI, Rev. 001. San Diego, CA: Hologic, Inc.; 2015.

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concluded that "there was insufficient evidence to recommend routine screening."

374:). Screening and its frequency is established after consulting with a geneticist. 3664: 3642: 2842: 2825: 2047: 396: 137: 109: 85:, so that men are informed of the risks and benefits of screening. In 2012, the 3337: 3032: 2162: 2146:"Review of Gallium-68 PSMA PET/CT Imaging in the Management of Prostate Cancer" 2099: 1640:"Digital Rectal Examination is Not a Useful Screening Test for Prostate Cancer" 1405: 1305:

Clinicians should not screen men who do not express a preference for screening.

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Ashley VA, Joseph MB, Kamlesh KY, Shalini SY, Ashutosh KT, Joseph R (2017).

2784: 2627: 2506: 1989: 1639: 293:. It is used to try to determine the risk of a Gleason score greater than 6. 275: 3437: 3415: 3345: 3298: 3253: 3193: 3058: 3009: 3001: 2960: 2903: 2859: 2810: 2742: 2635: 2587: 2525: 2474: 2422: 2376: 2319: 2246: 2193: 2181: 2073: 2016: 1957: 1900: 1851: 1797: 1748: 1663: 1554: 1537: 1520: 1505: 1431: 1387: 1369: 1338: 1300: 1291: 1274: 1252: 1200: 1073: 1034: 995: 933: 881: 837: 785: 728: 687: 626: 518: 3289: 3280: 3101: 2693: 2439:

Eskra JN, Rabizadeh D, Pavlovich CP, Catalona WJ, Luo J (September 2019).

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Screening with PSA has been associated with a number of harms including

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of men with healthy prostates, but is often elevated in the presence of

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Virgolini I, Decristoforo C, Haug A, Fanti S, Uprimny C (March 2018).

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The 4Kscore combines total, free and intact PSA together with human

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This article incorporates text from this source, which is in the

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This article incorporates text from this source, which is in the

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Velonas VM, Woo HH, dos Remedios CG, Assinder SJ (May 2013).

182:(DRE), a healthcare provider slides a gloved finger into the 61:

Screening precedes a diagnosis and subsequent treatment. The

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Ilic D, Neuberger MM, Djulbegovic M, Dahm P (January 2013).

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European Journal of Nuclear Medicine and Molecular Imaging

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Cognitive Registration. Is There a Preferred Technique?".

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Bennett HY, Roberts MJ, Doi SA, Gardiner RA (June 2016).

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Carroll PR, Whitson JM, Cooperberg MR (February 2011).

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has improved the diagnostic accuracy of the procedure.

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Cooperberg MR, Carroll PR, Klotz L (September 2011).

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PDQ Screening and Prevention Editorial Board (2018).

2441:"Approaches to urinary detection of prostate cancer" 3737: 3663: 3633: 3598: 3580: 3501: 2213:"Current status of theranostics in prostate cancer" 2139: 2137: 2135: 2133: 362:associated with prostate cancer development (e.g., 25: 20: 2547: 2545: 2543: 2541: 2539: 2537: 2535: 1165:"Current status of biomarkers for prostate cancer" 2973:: CS1 maint: DOI inactive as of September 2024 ( 2088:"MRI screening for prostate cancer shows promise" 513:. Bethesda (MD): National Cancer Institute (US). 2876:Siegel R, Naishadham D, Jemal A (January 2013). 2144:Lenzo NP, Meyrick D, Turner JH (February 2018). 1822:Biomedical Engineering and Computational Biology 1095:. San Francisco: American Society of Andrology. 550:"Prostate Cancer Screening-Professional Version" 447:urged "more caution in using the test." And the 2690:USPSTF Draft Prostate Screening Recommendations 1212: 1210: 797: 795: 426:Global comparisons of prostate cancer screening 3384:University of Bristol Dept. of Social Medicine 3127:The Big Scare: The Business of Prostate Cancer 3555:Transurethral needle ablation of the prostate 3478: 2680: 2678: 1604: 1602: 1457:"Prostate cancer - PSA testing - NHS Choices" 8: 3403:"The CAP (Comparison Arm for ProtecT) study" 1264: 1262: 327:United States Preventive Services Task Force 149:United States Preventive Services Task Force 2767:Fleshner K, Carlsson SV, Roobol MJ (2016). 1169:International Journal of Molecular Sciences 955: 953: 951: 597:The Cochrane Database of Systematic Reviews 3669: 3485: 3471: 3463: 3436: 3414: 3288: 3243: 3048: 2950: 2893: 2841: 2800: 2732: 2577: 2515: 2505: 2464: 2366: 2309: 2236: 2171: 2161: 2063: 2006: 1988: 1947: 1890: 1841: 1787: 1730: 1536: 1495: 1421: 1377: 1290: 1242: 1190: 1180: 985: 923: 871: 827: 775: 718: 616: 500: 498: 3119: 3117: 3115: 3113: 3111: 3538:Transurethral resection of the prostate 2830:Revista da Associação Médica Brasileira 2558:Canadian Urological Association Journal 2395:Critical Reviews in Oncology/Hematology 494: 449:American College of Preventive Medicine 3511:Transurethral incision of the prostate 2966: 2445:Prostate Cancer and Prostatic Diseases 1708: 1706: 1093:American Society of Andrology Handbook 478:Transurethral incision of the prostate 473:Active surveillance of prostate cancer 17: 3550:Transurethral microwave thermotherapy 3205: 3203: 3160:MayoClinic.com, updated March 6, 2010 2871: 2869: 2662:www.uspreventiveservicestaskforce.org 2434: 2432: 1811: 1809: 1807: 1451: 1449: 1046: 1044: 1007: 1005: 893: 891: 544: 542: 540: 538: 87:American Society of Clinical Oncology 7: 1865:Bjurlin MA, Taneja SS (1 May 2015). 1223:The Medical Clinics of North America 966:Canadian Medical Association Journal 849: 847: 586: 584: 582: 580: 3493:Tests and procedures involving the 3269:The New England Journal of Medicine 2882:CA: A Cancer Journal for Clinicians 2826:"PSA screening for prostate cancer" 2721:CA: A Cancer Journal for Clinicians 2339:Radiologic Clinics of North America 1977:Translational Andrology and Urology 1920:Radiologic Clinics of North America 707:CA: A Cancer Journal for Clinicians 46:process used to detect undiagnosed 2276:Bouchelouche K, Choyke PL (2018). 284:chromosome conformation signatures 14: 3710:Frenuloplasty of prepuce of penis 1269:Grossman DC, Curry SJ, Owens DK, 3543:Radical retropubic prostatectomy 2407:10.1016/j.critrevonc.2017.11.007 2257: This article incorporates 2252: 2192: This article incorporates 2187: 1331:10.1053/j.seminoncol.2017.02.001 565: 523: 511:PDQ Cancer Information Summaries 1867:"Standards for prostate biopsy" 1275:"Screening for Prostate Cancer" 593:"Screening for prostate cancer" 440:New England Journal of Medicine 405:American Urological Association 1877:(2). Curr Opin Urol: 155–161. 1816:Sarkar S, Das S (2016-03-02). 1593:Campbell's Urology 8th Edition 1459:. NHS Choices. 3 January 2015. 609:10.1002/14651858.cd004720.pub3 33:(when no symptoms are present) 1: 3124:Anthony Horan (August 2009). 1914:Turkbey B, Choyke PL (2018). 1476:The Annals of Family Medicine 1142:10.1016/S0022-5347(17)35233-3 3423:ISRCTN (November 19, 2007). 3037:Journal of Clinical Oncology 2294:10.1097/CCO.0000000000000439 1971:Giganti F, Moore CM (2017). 1883:10.1097/MOU.0000000000000031 1650:(6): S2588–9311(23)00203-1. 1410:Journal of Clinical Oncology 1066:10.1016/j.eururo.2016.07.041 1027:10.1016/j.eururo.2014.11.037 873:10.1016/j.eururo.2013.05.049 820:10.1016/j.eururo.2016.08.004 756:Journal of Clinical Oncology 641:"Prostate Cancer Guidelines" 142:benign prostatic hyperplasia 2843:10.1590/1806-9282.63.08.722 2282:Current Opinion in Oncology 2048:10.1001/jamaoncol.2020.7456 1219:"Prostate Cancer Screening" 1087:Hellstrom WJG, ed. (1999). 303:Prostate cancer antigen 3 ( 236:Transrectal ultrasonography 3807: 3338:10.1016/j.ejca.2009.09.008 3326:European Journal of Cancer 2333:Gaur S, Turkbey B (2018). 2163:10.3390/diagnostics8010016 2100:10.3310/nihrevidence_62211 1871:Current Opinion in Urology 1235:10.1016/j.mcna.2017.11.001 1217:Catalona WJ (March 2018). 904:Epidemiology and Infection 680:10.1016/j.juro.2012.11.014 242:Magnetic Resonance Imaging 174:Digital rectal examination 99:magnetic resonance imaging 63:digital rectal examination 3700: 3672: 3378:ProtecT (July 25, 2007). 2878:"Cancer statistics, 2013" 2457:10.1038/s41391-019-0127-4 2351:10.1016/j.rcl.2017.10.008 2229:10.1007/s00259-017-3882-2 1932:10.1016/j.rcl.2017.10.013 1656:10.1016/j.euo.2023.09.008 1644:European Urology Oncology 916:10.1017/S0950268815002885 554:National Cancer Institute 438:A study published in the 120:(PSA) is secreted by the 118:Prostate-specific antigen 113:Prostate-specific antigen 105:Prostate-specific antigen 67:prostate-specific antigen 40:Prostate cancer screening 21:Prostate cancer screening 3495:male reproductive system 3401:ISRCTN (March 6, 2006). 3094:10.1001/jama.276.24.1976 3050:10.1200/JCO.2010.32.5308 1828:(Suppl 1): BECB.S34255. 1423:10.1200/JCO.2011.34.9738 768:10.1200/JCO.2012.43.3441 2945:(inactive 2024-09-12). 2785:10.1038/nrurol.2016.251 2628:10.1021/acsnano.0c06946 2507:10.3390/cancers15030821 1990:10.21037/tau.2017.03.77 1762:Kim MJ (January 2015). 1690:www.hopkinsmedicine.org 445:American Cancer Society 349:National Health Service 334:American Cancer Society 3720:Penile plethysmography 3565:Prostate brachytherapy 3438:10.1186/ISRCTN20141297 3416:10.1186/ISRCTN92187251 3173:Biomarkers in Medicine 3002:10.1001/jama.2009.1498 2773:Nature Reviews Urology 1538:10.1001/jama.2018.3710 1370:10.1001/jama.2009.1348 1292:10.1001/jama.2018.3710 1130:The Journal of Urology 668:The Journal of Urology 427: 114: 83:shared decision-making 3281:10.1056/NEJMoa0810084 1182:10.3390/ijms140611034 454:A further study, the 425: 298:Prostate Health Index 112: 3776:Prostatic procedures 3771:Male genital surgery 3705:Foreskin restoration 3526:Transurethral biopsy 1319:Seminars in Oncology 483:Transurethral biopsy 3715:Penile Frenulectomy 3425:"The ProtecT trial" 1834:10.4137/BECB.S34255 978:10.1503/cmaj.140703 674:(1 Suppl): S2–S11. 360:germ-line mutations 347:As of 2018, the UK 3750:Scrotal ultrasound 3725:Postage stamp test 3623:Vasoepididymostomy 3613:Vasectomy reversal 3521:Transrectal biopsy 3228:10.1002/cncr.30904 2931:Reviews in Urology 2895:10.3322/caac.21166 2734:10.3322/caac.20066 2118:Prostate Cancer UK 1780:10.14366/usg.14051 1732:10.1002/cncr.22388 720:10.3322/caac.20066 428: 180:rectal examination 115: 3758: 3757: 3733: 3732: 3590:Spermatocelectomy 3222:(20): 3882–3894. 3186:10.2217/bmm.11.53 3137:978-1-58501-119-3 3130:. STERLINGHOUSE. 2570:10.5489/cuaj.4888 2114:"TRANSFORM trial" 2094:. 13 March 2024. 1686:"Prostate Biopsy" 1531:(18): 1901–1913. 1285:(18): 1901–1913. 1271:Bibbins-Domingo K 1102:978-1-891276-02-6 216:Prostate biopsies 178:During a digital 94:Prostate biopsies 37: 36: 3798: 3781:Cancer screening 3670: 3582:Seminal vesicles 3572:Prostate massage 3487: 3480: 3473: 3464: 3457: 3456: 3449: 3443: 3442: 3440: 3420: 3418: 3398: 3396: 3395: 3386:. Archived from 3375: 3369: 3368: 3366: 3365: 3356:. Archived from 3317: 3311: 3310: 3292: 3264: 3258: 3257: 3247: 3207: 3198: 3197: 3167: 3161: 3155: 3149: 3148: 3146: 3144: 3121: 3106: 3105: 3077: 3071: 3070: 3052: 3028: 3022: 3021: 2985: 2979: 2978: 2972: 2964: 2954: 2922: 2916: 2915: 2897: 2873: 2864: 2863: 2845: 2824:Sadi MV (2017). 2821: 2815: 2814: 2804: 2764: 2755: 2754: 2736: 2712: 2706: 2705: 2703: 2701: 2692:. Archived from 2682: 2673: 2672: 2670: 2668: 2654: 2648: 2647: 2610: 2601: 2598: 2592: 2591: 2581: 2549: 2530: 2529: 2519: 2509: 2485: 2479: 2478: 2468: 2436: 2427: 2426: 2390: 2381: 2380: 2370: 2330: 2324: 2323: 2313: 2273: 2267: 2256: 2250: 2240: 2208: 2202: 2191: 2185: 2175: 2165: 2141: 2128: 2127: 2125: 2124: 2110: 2104: 2103: 2084: 2078: 2077: 2067: 2027: 2021: 2020: 2010: 1992: 1968: 1962: 1961: 1951: 1911: 1905: 1904: 1894: 1862: 1856: 1855: 1845: 1813: 1802: 1801: 1791: 1759: 1753: 1752: 1734: 1710: 1701: 1700: 1698: 1697: 1682: 1676: 1675: 1635: 1629: 1628: 1626: 1625: 1616:. Archived from 1606: 1597: 1596: 1589: 1583: 1582: 1580: 1579: 1573:www.uptodate.com 1565: 1559: 1558: 1540: 1516: 1510: 1509: 1499: 1488:10.1370/afm.2205 1467: 1461: 1460: 1453: 1444: 1443: 1425: 1401: 1392: 1391: 1381: 1349: 1343: 1342: 1314: 1308: 1307: 1294: 1266: 1257: 1256: 1246: 1214: 1205: 1204: 1194: 1184: 1160: 1154: 1153: 1124: 1118: 1117: 1115: 1114: 1105:. Archived from 1084: 1078: 1077: 1054:European Urology 1048: 1039: 1038: 1015:European Urology 1013:meta-analysis". 1009: 1000: 999: 989: 957: 946: 945: 927: 895: 886: 885: 875: 860:European Urology 851: 842: 841: 831: 808:European Urology 799: 790: 789: 779: 747: 741: 740: 722: 698: 692: 691: 663: 657: 656: 654: 652: 637: 631: 630: 620: 588: 575: 569: 568: 564: 562: 561: 546: 533: 527: 526: 522: 502: 122:epithelial cells 18: 3806: 3805: 3801: 3800: 3799: 3797: 3796: 3795: 3786:Prostate cancer 3761: 3760: 3759: 3754: 3729: 3696: 3659: 3629: 3594: 3576: 3516:Prostate biopsy 3497: 3491: 3461: 3460: 3451: 3450: 3446: 3422: 3421: 3400: 3399: 3393: 3391: 3377: 3376: 3372: 3363: 3361: 3319: 3318: 3314: 3266: 3265: 3261: 3209: 3208: 3201: 3169: 3168: 3164: 3156: 3152: 3142: 3140: 3138: 3123: 3122: 3109: 3079: 3078: 3074: 3030: 3029: 3025: 2996:(15): 1685–92. 2987: 2986: 2982: 2965: 2943:10.3909/riu0772 2924: 2923: 2919: 2875: 2874: 2867: 2823: 2822: 2818: 2766: 2765: 2758: 2714: 2713: 2709: 2699: 2697: 2696:on 2 March 2018 2684: 2683: 2676: 2666: 2664: 2656: 2655: 2651: 2612: 2611: 2604: 2599: 2595: 2564:(10): 298–309. 2551: 2550: 2533: 2494:Cancers (Basel) 2487: 2486: 2482: 2438: 2437: 2430: 2392: 2391: 2384: 2332: 2331: 2327: 2275: 2274: 2270: 2210: 2209: 2205: 2143: 2142: 2131: 2122: 2120: 2112: 2111: 2107: 2086: 2085: 2081: 2029: 2028: 2024: 1970: 1969: 1965: 1913: 1912: 1908: 1864: 1863: 1859: 1815: 1814: 1805: 1768:Ultrasonography 1761: 1760: 1756: 1712: 1711: 1704: 1695: 1693: 1684: 1683: 1679: 1637: 1636: 1632: 1623: 1621: 1608: 1607: 1600: 1591: 1590: 1586: 1577: 1575: 1567: 1566: 1562: 1518: 1517: 1513: 1469: 1468: 1464: 1455: 1454: 1447: 1416:(27): 3669–76. 1403: 1402: 1395: 1351: 1350: 1346: 1316: 1315: 1311: 1268: 1267: 1260: 1216: 1215: 1208: 1175:(6): 11034–60. 1162: 1161: 1157: 1126: 1125: 1121: 1112: 1110: 1103: 1086: 1085: 1081: 1050: 1049: 1042: 1011: 1010: 1003: 972:(16): 1225–34. 959: 958: 949: 897: 896: 889: 853: 852: 845: 801: 800: 793: 749: 748: 744: 700: 699: 695: 665: 664: 660: 650: 648: 639: 638: 634: 603:(1): CD004720. 590: 589: 578: 566: 559: 557: 548: 547: 536: 524: 504: 503: 496: 491: 469: 420: 381: 322: 272: 253: 244: 233: 213: 208: 206:Follow-up tests 176: 160:prostate biopsy 134:prostate cancer 107: 50:in men without 48:prostate cancer 31:prostate cancer 12: 11: 5: 3804: 3802: 3794: 3793: 3788: 3783: 3778: 3773: 3763: 3762: 3756: 3755: 3753: 3752: 3747: 3745:Semen analysis 3741: 3739: 3735: 3734: 3731: 3730: 3728: 3727: 3722: 3717: 3712: 3707: 3701: 3698: 3697: 3695: 3694: 3692:Preputioplasty 3689: 3687:Penile implant 3684: 3679: 3673: 3667: 3661: 3660: 3658: 3657: 3652: 3651: 3650: 3639: 3637: 3631: 3630: 3628: 3627: 3626: 3625: 3620: 3610: 3604: 3602: 3596: 3595: 3593: 3592: 3586: 3584: 3578: 3577: 3575: 3574: 3569: 3568: 3567: 3557: 3552: 3547: 3546: 3545: 3540: 3530: 3529: 3528: 3523: 3513: 3507: 3505: 3499: 3498: 3492: 3490: 3489: 3482: 3475: 3467: 3459: 3458: 3444: 3370: 3312: 3290:2027.42/137255 3275:(13): 1320–8. 3259: 3199: 3162: 3150: 3136: 3107: 3088:(24): 1976–9. 3072: 3023: 2980: 2937:(4): 221–234. 2917: 2865: 2836:(8): 722–725. 2816: 2756: 2707: 2674: 2649: 2622:(3): 4054–65. 2602: 2593: 2531: 2480: 2451:(3): 362–381. 2428: 2382: 2345:(2): 263–275. 2325: 2288:(3): 189–196. 2268: 2223:(3): 471–495. 2203: 2129: 2105: 2092:NIHRE Evidence 2079: 2042:(3): 395–402. 2022: 1983:(3): 432–443. 1963: 1926:(2): 327–337. 1906: 1857: 1803: 1754: 1702: 1677: 1630: 1614:www.auanet.org 1598: 1584: 1560: 1511: 1482:(2): 149–154. 1462: 1445: 1393: 1364:(11): 1202–9. 1344: 1309: 1258: 1229:(2): 199–214. 1206: 1155: 1136:(5): 1283–90. 1119: 1101: 1079: 1060:(4): 517–531. 1040: 1001: 947: 910:(8): 1784–91. 887: 843: 814:(3): 353–365. 791: 762:(24): 3020–5. 742: 693: 658: 632: 576: 534: 493: 492: 490: 487: 486: 485: 480: 475: 468: 465: 419: 416: 380: 377: 376: 375: 358:Some men have 356: 352: 345: 341: 337: 330: 321: 318: 313: 312: 308: 301: 294: 287: 271: 268: 252: 249: 243: 240: 232: 229: 212: 209: 207: 204: 175: 172: 156:over-diagnosis 106: 103: 35: 34: 27: 23: 22: 13: 10: 9: 6: 4: 3: 2: 3803: 3792: 3789: 3787: 3784: 3782: 3779: 3777: 3774: 3772: 3769: 3768: 3766: 3751: 3748: 3746: 3743: 3742: 3740: 3736: 3726: 3723: 3721: 3718: 3716: 3713: 3711: 3708: 3706: 3703: 3702: 3699: 3693: 3690: 3688: 3685: 3683: 3680: 3678: 3675: 3674: 3671: 3668: 3666: 3662: 3656: 3653: 3649: 3646: 3645: 3644: 3641: 3640: 3638: 3636: 3632: 3624: 3621: 3619: 3618:Vasovasostomy 3616: 3615: 3614: 3611: 3609: 3606: 3605: 3603: 3601: 3597: 3591: 3588: 3587: 3585: 3583: 3579: 3573: 3570: 3566: 3563: 3562: 3561: 3560:Brachytherapy 3558: 3556: 3553: 3551: 3548: 3544: 3541: 3539: 3536: 3535: 3534: 3533:Prostatectomy 3531: 3527: 3524: 3522: 3519: 3518: 3517: 3514: 3512: 3509: 3508: 3506: 3504: 3500: 3496: 3488: 3483: 3481: 3476: 3474: 3469: 3468: 3465: 3454: 3448: 3445: 3439: 3434: 3430: 3426: 3417: 3412: 3408: 3404: 3390:on 2007-10-28 3389: 3385: 3381: 3374: 3371: 3360:on 2015-09-01 3359: 3355: 3351: 3347: 3343: 3339: 3335: 3332:(2): 377–83. 3331: 3327: 3323: 3316: 3313: 3308: 3304: 3300: 3296: 3291: 3286: 3282: 3278: 3274: 3270: 3263: 3260: 3255: 3251: 3246: 3241: 3237: 3233: 3229: 3225: 3221: 3217: 3213: 3206: 3204: 3200: 3195: 3191: 3187: 3183: 3180:(4): 515–26. 3179: 3175: 3174: 3166: 3163: 3159: 3154: 3151: 3139: 3133: 3129: 3128: 3120: 3118: 3116: 3114: 3112: 3108: 3103: 3099: 3095: 3091: 3087: 3083: 3076: 3073: 3068: 3064: 3060: 3056: 3051: 3046: 3042: 3038: 3034: 3027: 3024: 3019: 3015: 3011: 3007: 3003: 2999: 2995: 2991: 2984: 2981: 2976: 2970: 2962: 2958: 2953: 2948: 2944: 2940: 2936: 2932: 2928: 2921: 2918: 2913: 2909: 2905: 2901: 2896: 2891: 2887: 2883: 2879: 2872: 2870: 2866: 2861: 2857: 2853: 2849: 2844: 2839: 2835: 2831: 2827: 2820: 2817: 2812: 2808: 2803: 2798: 2794: 2790: 2786: 2782: 2778: 2774: 2770: 2763: 2761: 2757: 2752: 2748: 2744: 2740: 2735: 2730: 2726: 2722: 2718: 2711: 2708: 2695: 2691: 2687: 2681: 2679: 2675: 2663: 2659: 2653: 2650: 2645: 2641: 2637: 2633: 2629: 2625: 2621: 2617: 2609: 2607: 2603: 2597: 2594: 2589: 2585: 2580: 2575: 2571: 2567: 2563: 2559: 2555: 2548: 2546: 2544: 2542: 2540: 2538: 2536: 2532: 2527: 2523: 2518: 2513: 2508: 2503: 2499: 2495: 2491: 2484: 2481: 2476: 2472: 2467: 2462: 2458: 2454: 2450: 2446: 2442: 2435: 2433: 2429: 2424: 2420: 2416: 2412: 2408: 2404: 2400: 2396: 2389: 2387: 2383: 2378: 2374: 2369: 2364: 2360: 2356: 2352: 2348: 2344: 2340: 2336: 2329: 2326: 2321: 2317: 2312: 2307: 2303: 2299: 2295: 2291: 2287: 2283: 2279: 2272: 2269: 2266: 2264: 2260: 2255: 2248: 2244: 2239: 2234: 2230: 2226: 2222: 2218: 2214: 2207: 2204: 2201: 2199: 2195: 2190: 2183: 2179: 2174: 2169: 2164: 2159: 2155: 2151: 2147: 2140: 2138: 2136: 2134: 2130: 2119: 2115: 2109: 2106: 2101: 2097: 2093: 2089: 2083: 2080: 2075: 2071: 2066: 2061: 2057: 2053: 2049: 2045: 2041: 2037: 2036:JAMA Oncology 2033: 2026: 2023: 2018: 2014: 2009: 2004: 2000: 1996: 1991: 1986: 1982: 1978: 1974: 1967: 1964: 1959: 1955: 1950: 1945: 1941: 1937: 1933: 1929: 1925: 1921: 1917: 1910: 1907: 1902: 1898: 1893: 1888: 1884: 1880: 1876: 1872: 1868: 1861: 1858: 1853: 1849: 1844: 1839: 1835: 1831: 1827: 1823: 1819: 1812: 1810: 1808: 1804: 1799: 1795: 1790: 1785: 1781: 1777: 1773: 1769: 1765: 1758: 1755: 1750: 1746: 1742: 1738: 1733: 1728: 1724: 1720: 1716: 1709: 1707: 1703: 1691: 1687: 1681: 1678: 1673: 1669: 1665: 1661: 1657: 1653: 1649: 1645: 1641: 1634: 1631: 1620:on 2017-02-06 1619: 1615: 1611: 1605: 1603: 1599: 1594: 1588: 1585: 1574: 1570: 1564: 1561: 1556: 1552: 1548: 1544: 1539: 1534: 1530: 1526: 1522: 1515: 1512: 1507: 1503: 1498: 1493: 1489: 1485: 1481: 1477: 1473: 1466: 1463: 1458: 1452: 1450: 1446: 1441: 1437: 1433: 1429: 1424: 1419: 1415: 1411: 1407: 1400: 1398: 1394: 1389: 1385: 1380: 1375: 1371: 1367: 1363: 1359: 1355: 1348: 1345: 1340: 1336: 1332: 1328: 1324: 1320: 1313: 1310: 1306: 1302: 1298: 1293: 1288: 1284: 1280: 1276: 1272: 1265: 1263: 1259: 1254: 1250: 1245: 1240: 1236: 1232: 1228: 1224: 1220: 1213: 1211: 1207: 1202: 1198: 1193: 1188: 1183: 1178: 1174: 1170: 1166: 1159: 1156: 1151: 1147: 1143: 1139: 1135: 1131: 1123: 1120: 1109:on 2010-01-12 1108: 1104: 1098: 1094: 1090: 1083: 1080: 1075: 1071: 1067: 1063: 1059: 1055: 1047: 1045: 1041: 1036: 1032: 1028: 1024: 1021:(3): 438–50. 1020: 1016: 1008: 1006: 1002: 997: 993: 988: 983: 979: 975: 971: 967: 963: 956: 954: 952: 948: 943: 939: 935: 931: 926: 921: 917: 913: 909: 905: 901: 894: 892: 888: 883: 879: 874: 869: 866:(6): 876–92. 865: 861: 857: 850: 848: 844: 839: 835: 830: 825: 821: 817: 813: 809: 805: 798: 796: 792: 787: 783: 778: 773: 769: 765: 761: 757: 753: 746: 743: 738: 734: 730: 726: 721: 716: 712: 708: 704: 697: 694: 689: 685: 681: 677: 673: 669: 662: 659: 646: 642: 636: 633: 628: 624: 619: 614: 610: 606: 602: 598: 594: 587: 585: 583: 581: 577: 573: 572:public domain 555: 551: 545: 543: 541: 539: 535: 531: 530:public domain 520: 516: 512: 508: 501: 499: 495: 488: 484: 481: 479: 476: 474: 471: 470: 466: 464: 461: 457: 452: 450: 446: 441: 436: 432: 424: 417: 415: 412: 408: 406: 400: 398: 393: 391: 385: 378: 373: 369: 365: 361: 357: 353: 350: 346: 342: 338: 335: 331: 328: 324: 323: 319: 317: 309: 306: 302: 299: 295: 292: 288: 285: 281: 280: 279: 277: 269: 267: 265: 261: 257: 251:Other imaging 250: 248: 241: 239: 237: 230: 228: 226: 222: 217: 210: 205: 203: 199: 195: 191: 188: 185: 181: 173: 171: 168: 163: 161: 157: 152: 150: 145: 143: 139: 135: 131: 127: 123: 119: 111: 104: 102: 100: 95: 91: 88: 84: 79: 76: 72: 69:(PSA) in the 68: 64: 59: 57: 53: 49: 45: 41: 32: 28: 24: 19: 16: 3791:Men's health 3677:Circumcision 3600:Vas deferens 3447: 3428: 3406: 3392:. 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