Towards More Targeted Prostate Cancer Screening
Moving Beyond PSA Testing Alone
For decades, prostate-specific antigen (PSA) testing has played a role in the early detection of prostate cancer.
However, its use in screening during the 1980s and 1990s also revealed important limitations, particularly the detection of cancers that would never become aggressive or life-threatening.
Concerns about overdiagnosis and unnecessary treatment eventually contributed to the discontinuation of earlier PSA-based screening practices.
In this video interview, Silvia Deandrea, Senior Expert/Researcher at ATS Pavia and EUCanScreen Task 6.1 Leader, discusses how prostate cancer screening is being reconsidered through Italian and European pilot projects, including initiatives coordinated at European level through the Joint Action.
Moving Beyond PSA Testing Alone
Unlike the indiscriminate use of PSA testing in previous decades, the protocols currently being investigated introduce additional diagnostic steps to assess the likelihood of disease progression.
When PSA levels are abnormal, the person undergoes a urological examination, including a digital rectal examination. If necessary, magnetic resonance imaging (MRI) provides further information to support the assessment.
Combining these examinations with an evaluation of the risk of lesion progression is intended to help distinguish potentially aggressive cancers that may require treatment, including surgery, from those unlikely to progress.
Exploring new screening protocols through European cooperation
Pilot projects in Italy and across Europe are examining the possibility of reintroducing prostate cancer screening through risk-based protocols, rather than relying on PSA testing alone.
These initiatives are investigating how additional diagnostic assessments can inform screening pathways and treatment decisions, addressing the limitations that led to the discontinuation of earlier screening practices.
A new approach to PSA screening, designed to reduce overdiagnosis without losing the benefits of early detection.
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Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or European Health and Digital Executive Agency (HaDEA). Neither the European Union nor HaDEA can be held responsible for them.
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This project has received funding from the European Union’s EU4HEALTH Programme under the Grant Agreement no 101162959