Summary statement on screening for prostate cancer in Europe.
Heijnsdijk EAMDepartment of Public Health, Erasmus Medical Center, Wytemaweg 80, CN Rotterdam, 3015, The Netherlands.
Bangma CHDepartment of Urology, Erasmus Medical Center, Wytemaweg 80, CN Rotterdam, 3015, The Netherlands.
Borràs JMDepartment of Health, Catalan Institute of Oncology, Avinguda de la Granvia de l'Hospitalet 199-203, Barcelona, 08908, Spain.
de Carvalho TMDepartment of Public Health, Erasmus Medical Center, Wytemaweg 80, CN Rotterdam, 3015, The Netherlands.
Castells XDepartment of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim, 25-29, Barcelona, 08003, Spain.
Eklund MDepartment of medical epidemiology and biostatistics, Karolinska Institutet, Karolinska vägen, Solna, Stockholm, 171 76, Sweden.
Espinàs JADepartment of Health, Catalan Institute of Oncology, Avinguda de la Granvia de l'Hospitalet 199-203, Barcelona, 08908, Spain.
Graefen MMartini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistrasse 52 Building O43, Hamburg, 20246, Germany.
Grönberg HDepartment of medical epidemiology and biostatistics, Karolinska Institutet, Karolinska vägen, Solna, Stockholm, 171 76, Sweden.
Lansdorp-Vogelaar IDepartment of Public Health, Erasmus Medical Center, Wytemaweg 80, CN Rotterdam, 3015, The Netherlands.
Leeuwen PJVDepartment of Urology, Erasmus Medical Center, Wytemaweg 80, CN Rotterdam, 3015, The Netherlands.
Nelen VProvinciaal Instituut voor Hygiëne, Kronenburgstraat 45, Antwerp, 2000, Belgium.
English
The European Randomised Study of Screening for Prostate Cancer (ERSPC) showed that Prostate-Specific Antigen (PSA) based screening results in a significant prostate cancer mortality reduction. Although there are concerns on overdiagnosis and overtreatment, it has been shown that the benefits can outweigh the harms if screening is stopped in older ages to prevent overdiagnosis. A limited screening program (for example screening at ages 55-59 years), including active surveillance for men with low-risk tumors, can even be cost-saving, compared with testing in an opportunistic setting in the wrong ages, as currently in Europe. Further improvements are expected in the use of active surveillance and in discrimination between indolent and significant disease due to new biomarkers and magnetic resonance imaging. However, these future developments are no reason to postpone feasibility studies of high-quality PSA screening and reduce opportunistic testing at old ages.