Adherence to a risk-adapted screening strategy for prostate cancer: First results of the PROBASE trial

Krilaviciute A, Albers P, Lakes J, Radtke JP, Herkommer K, Gschwend J, Peters I, Kuczyk M, Koerber SA, Debus J, Kristiansen G, Schimmoller L, Antoch G, Makowski M, Wacker F, Schlemmer H, Benner A, Giesel F, Siener R, Arsov C, Hadaschik B, Becker N, Kaaks R (2023)

Publication Type: Journal article

Publication year: 2023

Journal

International Journal of Cancer Wiley-Blackwell

Book Volume: 152

Pages Range: 854-864

Journal Issue: 5

DOI: 10.1002/ijc.34295

Abstract

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.

Involved external institutions

Technische Universität München (TUM) DE Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School DE Germany (DE) Deutsches Krebsforschungszentrum (DKFZ) DE Germany (DE) Heinrich-Heine-Universität Düsseldorf DE Germany (DE) Ruprecht-Karls-Universität Heidelberg DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE)

How to cite

APA:

Krilaviciute, A., Albers, P., Lakes, J., Radtke, J.P., Herkommer, K., Gschwend, J.,... Kaaks, R. (2023). Adherence to a risk-adapted screening strategy for prostate cancer: First results of the PROBASE trial. International Journal of Cancer, 152(5), 854-864. https://doi.org/10.1002/ijc.34295

MLA:

Krilaviciute, Agne, et al. "Adherence to a risk-adapted screening strategy for prostate cancer: First results of the PROBASE trial." International Journal of Cancer 152.5 (2023): 854-864.

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