ABSTRACT
Prostate cancer mortality using current diagnostic tools can be reduced, but at the cost of too many biopsies and overtreatment. Prostate cancer is currently diagnosed using prostate-specic antigen (PSA) testing and systematic ultrasound (sysUS) biopsy. e common PSA test misses 15% of cancers and causes false alarm in 65%–75% of the normal cases, resulting in many unnecessary biopsies. e poor specicity results from elevated PSA levels at benign conditions such as prostatitis or benign prostatic hyperplasia (BPH). Furthermore, sysUS biopsies after PSA testing miss at least 20% of cancers and undergrade the cancers in 50% of the cases. e uncertainty of the tumor aggressiveness leads to overtreatment. Using PSA + sysUS biopsy as screening tool can reduce 25% of prostate cancer mortality (Schröder et al. 2009). However, the amount of unnecessary biopsies and overtreatment is considered too large to justify screening.
