PCa: Balancing advantages and disadvantages of early detection

“The screening and early detection of prostate cancer has of course been a hot topic in urology for many years (EORTC, Stockholm 3). At EAU21, we’re addressing the issue in a “nightmare session” with consultant solicitor Mr. Bertie Leigh.”

“It’s very important to be aware of the advantages and disadvantages of early detection, and the risks associated with it. Unfortunately, in medicine nothing is ever a 100% vs a 0% recommendation. You always have to balance advantages and disadvantages when considering treatment options or indeed screening for PCa. You have to balance the risk of overdiagnosis and overtreatment, with the risk of underdiagnosis and undertreatment.”

“The plenary session on early detection will highlight details that urologists always have to keep in mind with early detection. In addition to the respective risks of over- and underdiagnosis, we have to be careful when we rely only on imaging, and then miss the disease because we overestimate capacity of the technology.”

“The use of MRI for PCa detection is maturing and more widespread, but quality is still an issue. Not every MRI achieves the necessary quality to be helpful and reliable. There is a quality issue, so we have to work closely with radiologists on a European level.”

“Beyond the plenary and thematic sessions, we received a lot of abstracts on topics that deal with new technology and surgery. Notably, a lot of abstracts looking at PCa recurrence and a post-treatment rise in PSA. Another hot topic is how to best use MRI as a triage test, and how much we can depend on this technology.”

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