What's new in screening in 2015?

The aim of this review was to highlight important articles in the field of prostate cancer screening published during 2015 and early 2016. Four major areas were identified for the purpose: screening strategies, post-United States Preventive Services Task Force (USPSTF) 2011-2012, screening trends/patterns, and shared decision making.

Several studies furthered the evidence that screening reduces the risk of metastasis and death from prostate cancer. Multiplex screening strategies are of proven benefit; genetics and MRI need further evaluation. Prostate-specific antigen (PSA) screening rates declined in men above of age 50 years, as did the overall prostate cancer incidence following the USPSTF 2011-2012 recommendation against PSA. The consequences of declining screening rates will become apparent in the next few years. More research is needed to identify the most optimal approach to engage in, and implement, an effective shared decision making in clinical practice.

Data emerging in 2015 provided evidence on the question of how best to screen and brought more steps in the right direction of 'next-generation prostate cancer screening'. Screening is an ongoing process in all men regardless of or not whether they are benefited from early detection and treatment. After the USPSTF 2011-2012 recommendation, the rates of PSA testing are declining; however, this decline is observed in all men and not solely in those who will not benefit from the screening. The long-term effect of this recommendation might not be as anticipated. More studies are needed on how to implement the best available evidence on who, and when, to screen into clinical practice.

Current opinion in urology. 2016 Jun 17 [Epub ahead of print]

Sigrid V Carlsson, Monique J Roobol

aMemorial Sloan Kettering Cancer Center, Department of Surgery and Epidemiology & Biostatistics, New York, USA bInstitute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden cDepartment of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands.

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