Loading
Whether men should be screened for prostate cancer is still debated; the modern approach uses a PSA blood test followed by an MRI scan, which finds the cancers that matter while leaving harmless ones alone.
The European ERSPC trial showed that PSA screening reduces prostate cancer mortality (rate ratio 0.80 at 16 years, with 570 men invited and 18 diagnosed per death averted), while the UK CAP trial of a single PSA test found only a small absolute difference at 15 years (0.69% versus 0.78% prostate cancer deaths). Overdiagnosis of low-grade disease was the price. The Göteborg-2 trial (NEJM 2022) showed that using MRI after an elevated PSA and biopsying only MRI-visible lesions halved the detection of clinically insignificant cancer while missing few significant cancers, and PROBASE in Germany is testing risk-adapted screening from age 45. In the UK, TRANSFORM (Prostate Cancer UK and government funded, opened 2025-26) compares PSA, fast MRI and genetic risk approaches in tens of thousands of men, with at least one in ten Black men, ahead of a decision on a national programme; the UK National Screening Committee has not recommended population screening. The USPSTF gives a grade C (individual decision) for men 55 to 69, and the EU Council in 2022 asked member states to evaluate stepwise PSA-plus-MRI programmes.
A PSA threshold selects men for multiparametric or biparametric MRI; only PI-RADS 3-5 lesions are biopsied, with active surveillance for low-grade disease.
One technology page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
One technology page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
The evidence that put a scan in front of the biopsy. It reduces the number of men who are biopsied at all, reduces the number of harmless cancers found, and increases the number of dangerous ones, which is the only combination that improves a screening pathway on both sides at once.
The evidence that prostate-specific antigen screening works, stated together with the price. It is the reason screening programmes are debated rather than simply adopted, and the reason every subsequent proposal, from magnetic resonance imaging first to risk-model invitation, is judged on whether it keeps the mortality benefit while reducing the 48.
Query for this technology: (TITLE:"PSA and MRI-first prostate cancer screening" OR ABSTRACT:"PSA and MRI-first prostate cancer screening") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about PSA and MRI-first prostate cancer screening, not a curated reading list.
Shares GÖTEBORG-2 (MRI-based prostate cancer screening), Polygenic risk score (PRS), Number needed to screen (and number needed to diagnose), PI-RADS (Prostate Imaging Reporting and Data System).
Shares A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer, Lead time, and lead-time bias, Number needed to screen (and number needed to diagnose), ERSPC: screening and prostate cancer mortality in a randomised European study.
Shares PRECISION, TRANSFORM, Multiparametric prostate MRI (PI-RADS), Template mapping biopsy (transperineal template prostate mapping).
Shares PRECISION, Template mapping biopsy (transperineal template prostate mapping), PI-RADS (Prostate Imaging Reporting and Data System), PROMIS: diagnostic accuracy of multiparametric MRI and TRUS biopsy in prostate cancer.
Shares Lead time, and lead-time bias, Overtreatment, Judge a prostate screening programme on metastatic presentation, not on incidence or mortality, Overdiagnosis.
Shares Prostate-Specific Antigen Screening and 15-Year Prostate Cancer Mortality: A Secondary Analysis of the CAP Randomized Clinical Trial, Lead time, and lead-time bias, Number needed to screen (and number needed to diagnose), ERSPC: screening and prostate cancer mortality in a randomised European study.
Shares Lead time, and lead-time bias, ERSPC: screening and prostate cancer mortality in a randomised European study, Overtreatment, Overdiagnosis.
Shares Template mapping biopsy (transperineal template prostate mapping), PI-RADS (Prostate Imaging Reporting and Data System), PROMIS: diagnostic accuracy of multiparametric MRI and TRUS biopsy in prostate cancer, Publish a per-lesion miss rate for every prostate MRI service before it is allowed to guide focal treatment.
Open-source projects that implement or serve this technology, from OnCo's own catalogue: licence and last activity as the repository reported them on the day of the fetch. Listing is not endorsement; check the licence before reuse and the validation before clinical use.
Preprocessing from the PI-CAI challenge for AI detection of clinically significant prostate cancer on biparametric MRI.