TY - JOUR
T1 - Adherence to a risk-adapted screening strategy for prostate cancer
T2 - First results of the PROBASE trial
AU - Krilaviciute, Agne
AU - Albers, Peter
AU - Lakes, Jale
AU - Radtke, Jan Philipp
AU - Herkommer, Kathleen
AU - Gschwend, Jürgen
AU - Peters, Inga
AU - Kuczyk, Markus
AU - Koerber, Stefan A.
AU - Debus, Jürgen
AU - Kristiansen, Glen
AU - Schimmöller, Lars
AU - Antoch, Gerald
AU - Makowski, Marcus
AU - Wacker, Frank
AU - Schlemmer, Heinz
AU - Benner, Axel
AU - Giesel, Frederik
AU - Siener, Roswitha
AU - Arsov, Christian
AU - Hadaschik, Boris
AU - Becker, Nikolaus
AU - Kaaks, Rudolf
N1 - Publisher Copyright:
© 2022 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
PY - 2023/3/1
Y1 - 2023/3/1
N2 - PROBASE is a population-based, randomized trial of 46 495 German men recruited at age 45 to compare effects of risk-adapted prostate cancer (PCa) screening starting either immediately at age 45, or at a deferred age of 50 years. Based on prostate-specific antigen (PSA) levels, men are classified into risk groups with different screening intervals: low-risk (<1.5 ng/ml, 5-yearly screening), intermediate-risk (1.5-2.99 ng/ml, 2 yearly), and high risk (>3 ng/ml, recommendation for immediate biopsy). Over the first 6 years of study participation, attendance rates to scheduled screening visits varied from 70.5% to 79.4%, depending on the study arm and risk group allocation, in addition 11.2% to 25.4% of men reported self-initiated PSA tests outside the PROBASE protocol. 38.5% of participants had a history of digital rectal examination or PSA testing prior to recruitment to PROBASE, frequently associated with family history of PCa. These men showed higher rates (33% to 57%, depending on subgroups) of self-initiated PSA testing in-between PROBASE screening rounds. In the high-risk groups (both arms), the biopsy acceptance rate was 64% overall, but was higher among men with screening PSA ≥4 ng/ml (>71%) and with PIRADS ≥3 findings upon multiparameter magnetic resonance imaging (mpMRI) (>72%), compared with men with PSA ≥3 to 4 ng/ml (57%) or PIRADS score ≤ 2 (59%). Overall, PROBASE shows good acceptance of a risk-adapted PCa screening strategy in Germany. Implementation of such a strategy should be accompanied by a well-structured communication, to explain not only the benefits but also the harms of PSA screening.
AB - PROBASE is a population-based, randomized trial of 46 495 German men recruited at age 45 to compare effects of risk-adapted prostate cancer (PCa) screening starting either immediately at age 45, or at a deferred age of 50 years. Based on prostate-specific antigen (PSA) levels, men are classified into risk groups with different screening intervals: low-risk (<1.5 ng/ml, 5-yearly screening), intermediate-risk (1.5-2.99 ng/ml, 2 yearly), and high risk (>3 ng/ml, recommendation for immediate biopsy). Over the first 6 years of study participation, attendance rates to scheduled screening visits varied from 70.5% to 79.4%, depending on the study arm and risk group allocation, in addition 11.2% to 25.4% of men reported self-initiated PSA tests outside the PROBASE protocol. 38.5% of participants had a history of digital rectal examination or PSA testing prior to recruitment to PROBASE, frequently associated with family history of PCa. These men showed higher rates (33% to 57%, depending on subgroups) of self-initiated PSA testing in-between PROBASE screening rounds. In the high-risk groups (both arms), the biopsy acceptance rate was 64% overall, but was higher among men with screening PSA ≥4 ng/ml (>71%) and with PIRADS ≥3 findings upon multiparameter magnetic resonance imaging (mpMRI) (>72%), compared with men with PSA ≥3 to 4 ng/ml (57%) or PIRADS score ≤ 2 (59%). Overall, PROBASE shows good acceptance of a risk-adapted PCa screening strategy in Germany. Implementation of such a strategy should be accompanied by a well-structured communication, to explain not only the benefits but also the harms of PSA screening.
KW - PSA
KW - compliance
KW - contamination
KW - prostate cancer
KW - prostate-specific antigen
KW - screening
UR - http://www.scopus.com/inward/record.url?scp=85139193443&partnerID=8YFLogxK
U2 - 10.1002/ijc.34295
DO - 10.1002/ijc.34295
M3 - Article
C2 - 36121664
AN - SCOPUS:85139193443
SN - 0020-7136
VL - 152
SP - 854
EP - 864
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 5
ER -