Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Objectives: Our objective was to compare prostate cancer detection rates between patients undergoing serum prostate-specific antigen (PSA) vs magnetic resonance imaging (MRI) for prostate cancer screening.
Design: Phase III open-label randomised controlled trial.
Setting: Single tertiary cancer centre in Toronto, Canada.
Participants: Men 50 years of age and older with no history of PSA screening for ≥3 years, a negative digital rectal exam and no prior prostate biopsy.
Interventions: Patients were recommended to undergo a prostate biopsy if their PSA was ≥2.6 ng/mL (PSA arm) or if they had a PIRADS score of 4 or 5 (MRI arm). Patients underwent an end-of-study PSA in the MRI arm.
Primary And Secondary Outcome Measures: Adenocarcinoma on prostate biopsy. Prostate biopsy rates and the presence of clinically significant prostate cancer were also compared.
Results: A total of 525 patients were randomised, with 266 in the PSA arm and 248 in the MRI arm. Due to challenges with accrual and study execution during the COVID-19 pandemic, the study was terminated early. In the PSA arm, 48 patients had an abnormal PSA and 28 (58%) agreed to undergo a prostate biopsy. In the MRI arm, 25 patients had a PIRADS score of 4 or 5 and 24 (96%) agreed to undergo a biopsy. The relative risk for MRI to recommend a prostate biopsy was 0.52 (95% CI 0.33 to 0.82, p=0.005), compared with PSA. The cancer detection rate for patients in the PSA arm was 29% (8 of 28) vs 63% (15 of 24, p=0.019) in the MRI arm, with a higher proportion of clinically significant cancer detected in the MRI arm (73% vs 50%). The relative risk for detecting cancer and clinically significant with MRI compared with PSA was 1.89 (95% CI 0.82 to 4.38, p=0.14) and 2.77 (95% CI 0.89 to 8.59, p=0.07), respectively.
Conclusions: Prostate MRI as a stand-alone screening test reduced the rate of prostate biopsy. The number of clinically significant cancers detected was higher in the MRI arm, but this did not reach statistical significance. Due to early termination, the study was underpowered. More patients were willing to follow recommendations for prostate biopsy based on MRI results.
Trial Registration Number: NCT02799303.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9644313 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2021-059482 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impact of sociodemographic and socioeconomic factors on functional and health-related quality of life outcomes 24 months after radical prostatectomy.
J Cancer Res Clin Oncol
September 2025
Department of Urology, University Hospital Tübingen, Eberhard Karls University, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany.
Introduction And Objectives: High socioeconomic status (SES) is associated with improved oncological outcomes across various cancer types, including prostate cancer. However, limited evidence exists regarding the impact of SES and lifestyle factors on patient-reported outcomes (PROs), including quality of life (QoL), health status (HS), and functional recovery following radical prostatectomy (RP).
Materials And Methods: We conducted a retrospective single-center analysis of 327 patients undergoing RP (177 open, 150 robotic-assisted) assessing pre- and postoperative functional outcomes (QoL, HS, erectile function, continence).
Synthesis, preclinical evaluation and clinical application of a novel heterodimeric tracer Ga-pentixafor-c(RGDfK) for PET-CT imaging.
Eur J Nucl Med Mol Imaging
September 2025
Department of PET-CT/MRI, NHC Key Laboratory of Molecular Probe and Targeted Theranostics, Harbin Medical University Cancer Hospital, Harbin, 150081, Heilongjiang, China.
Objective: CXCR4 and integrin αβ play important roles in tumor biology and are highly expressed in multiple types of tumors. This study aimed to synthesize, preclinically evaluate, and clinically validate a novel dual-targeted PET imaging probe Ga-pentixafor-c(RGDfK) for its potential in imaging tumors.
Methods: The effects of Ga-pentixafor-c(RGDfK) on cell viability, targeting specificity, and affinity were assessed in the U87MG cells.
Prostate cancer with favourable histology is not synonymous with prostate cancer indolence.
Histopathology
September 2025
Institute of Pathology, University Hospital Bonn, Bonn, Germany.
Relugolix for Metastatic Hormone-sensitive Prostate Cancer with Impending Paraplegia.
Ann Afr Med
September 2025
Department of Pathology, Dr. Lal Path Labs, New Delhi, India.
Luteinizing hormone-releasing hormone agonists, used in advanced prostate cancer, can cause an initial testosterone surge and may inadequately suppress follicle-stimulating hormone, potentially promoting tumor growth. Injectable gonadotropin-releasing hormone (GnRH) antagonists avoid this surge but have drawbacks like injection-site reactions and monthly dosing. Relugolix, an oral GnRH antagonist, offers rapid testosterone suppression without flare and reduced cardiovascular risks.
View Article and Find Full Text PDFExploring the Functional Role of Programmed Death-Ligand 1 (PD-L1) in the Castration-Resistant Prostate Cancer Using Transcriptomic Sequencing Analysis.
Cancer Med
September 2025
The Key Laboratory of Tumor Stem Cell Research of Liaoning Province, Dalian Medical University, Dalian, China.
Background: Prostate cancer is one of the principal malignancies threatening human health, and the development of castration resistance often constitutes a major cause of treatment failure in its management.
Methods: To elucidate the potential association between programmed death-ligand 1 (PD-L1) and castration resistance in prostate cancer, we analyzed the expression levels of PD-L1 in both primary prostate cancer tissues and castration-resistant prostate cancer (CRPC) specimens as well as in corresponding cell lines by using western blots and immunohistochemistry. Then, we explored the specific mechanisms through transcriptomic sequencing technology.