Huang Yubei

M.D., Ph.D

Tianjin Medical University Cancer Institute and Hospital

Research Associate

PLCO (Learn more about this study)

PLCO-1072

Oct 11, 2022

Risk-stratified multi-round PSA screening for prostate cancer incorporating population-based screening reference level and subgroup-specific progression indicators

Although prostate-specific antigen (PSA) is widely used in prostate cancer (PCa) screening, nearly half of PCa cases are missed under the traditional PSA screening strategy. The adoption of PSA diagnostic criteria for PCa in population-based screening is presumed to be the leading cause of the missed PCa. Since most of the screening population are healthy men, and only a minority of men have PSA above the diagnostic criteria. Moreover, to improve the effectiveness of PSA screening for PCa, many studies have proposed several new strategies to cope with the above limitations of PSA screening. As observed in STHLM3-MRI, screening using a combination of risk-prediction, magnetic resonance imaging (MRI), and targeted prostate biopsies has shown the potential to reduce over-detection while maintain the ability to detect clinically significant cancer. However, MRI is not readily available in many resource-limited settings. Additionally, several PSA progression indicators based on repeated PSA tests have been also proposed to improve the effectiveness of PSA screening, such as PSA velocity and doubling time, etc. However, most of these progression indicators are used for prognostic monitoring of PCa, few studies have investigated the performance and differences between these PSA progression indicators under the setting of population-based screening. In summary, it is necessary to determine the PSA reference level for population-based PCa screening, investigate the effects of PSA progression indicators under the setting of population-based screening, and finally propose a new PSA screening strategy for PCa.