title: Prostate-specific antigen-based prostate cancer screening: Past and future.
abstract: Prostate-specific antigen-based prostate cancer screening remains a controversial topic. Up to now, there is worldwide consensus on the statement that the harms of population-based screening, mainly as a result of overdiagnosis (the detection of clinically insignificant tumors that would have never caused any symptoms), outweigh the benefits. However, worldwide opportunistic screening takes place on a wide scale. The European Randomized Study of Screening for Prostate Cancer showed a reduction in prostate cancer mortality through prostate-specific antigen based-screening. These population-based data need to be individualized in order to avoid screening in those who cannot benefit and start screening in those who will. For now, lacking a more optimal screening approach, screening should only be started after the process of shared decision-making. The focus of future research is the reduction of unnecessary testing and overdiagnosis by further research to better biomarkers and the value of the multiparametric magnetic resonance imaging, potentially combined in already existing prostate-specific antigen-based multivariate risk prediction models.
authors.affiliation: Department of Urology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Arnout R
authors.initials: AR
authors.lastname: Alberts
authors.affiliation: Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Ivo G
authors.initials: IG
authors.lastname: Schoots
authors.affiliation: Department of Urology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Monique J
authors.initials: MJ
authors.lastname: Roobol
mesh_terms: D001706:Biopsy / Q000009:adverse effects; D055088:Early Detection of Cancer; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017410:Practice Guidelines as Topic; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D019564:Unnecessary Procedures; D057832:Watchful Waiting
chemical_list: D017430:Prostate-Specific Antigen
keywords: PSA; guidelines; multiparametric MRI; prostate cancer; risk assessment; screening