title: Identification and evaluation of clinically significant prostate cancer: a step towards personalized diagnosis.
abstract: OBJECTIVE
  Prostate cancer (PCa) diagnostics are evolving rapidly. The quest to differentiate 'clinically significant' from 'clinically insignificant' disease has gathered momentum, leading to substantial change in traditional diagnostic approaches. Herein, we review the relevant information on currently available biomarkers and assess their ability to help physicians and patients in making a shared and personalized decision based on their individual risk of harbouring clinically significant disease.
  
  
  RESULTS
  Serum, urine, tissue and imaging biomarkers have been evaluated to improve the identification of clinically significant disease, and this international effort has yielded promising, but not always consistent results. Changes in MRI technology have realized a quantum change, and this facility is now becoming more widely incorporated into diagnostic and disease risk-stratification protocols. However, standardization and further validation is required.
  
  
  CONCLUSIONS
  Acceptance and widespread adoption of serum, urine and genetic markers is awaited, but novel and promising techniques alone and in combination have emerged. With validation and further focus, these may be adopted more widely.
authors.affiliation: aProstate Oncobiology bCancer Research UK Manchester Institute cBelfast-Manchester Movember Centre of Excellence, Cancer Research UK Manchester Institute, University of Manchester dDepartment of Surgery, The Christie NHS Foundation Trust, Manchester eDepartment of Urology, Salford NHS Foundation Trust, Salford, UK.
authors.forename: Adnan
authors.initials: A
authors.lastname: Ali
authors.forename: Alexander
authors.initials: A
authors.lastname: Hoyle
authors.forename: Esther
authors.initials: E
authors.lastname: Baena
authors.forename: Noel W
authors.initials: NW
authors.lastname: Clarke
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics*; D006801:Humans; D008297:Male; D057285:Precision Medicine; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000628:therapy
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen