Stages of development of prostate cancer screening

Prostate cancer (PCa) is one of the most common cancers worldwide. In Russia, prostate cancer ranks first in the incidence of malignant neoplasms (MN) among the male population, accounting for 17% of the total incidence of MN among men. The main strategy to counteract the growing spread of PCa is the introduction of evidence-based preventive measures into practical healthcare, including effective models for PCa screening. The search for literature data was carried out on the basis of electronic sources in International scientific databases: PubMed/MEDLINE, Google, RusMed. The review presents data and results of studies devoted to the development, implementation and evaluation of the effectiveness of various models and programs for PCa screening. The following diagnostic tests were used for population PCa screening: digital rectal examination, prostate-specific antigen (PSA) blood test, ultrasound and magnetic resonance imaging. The most common is the PSA blood test. Many studies have shown that the use of this test in population-based screening programs can reduce mortality from PCa by 20% or more. However, screening with PSA also leads to harmful consequences: overdiagnosis, unnecessary biopsies, and treatment. In the last decade, new tests and models for PCa screening have been developed, which significantly increase the effectiveness of screening and reduce its negative consequences. In modern guidelines for PCa screening, it is recommended to replace examination of all men of certain age groups with the same test and in the same mode with screening adapted to PCa individual risk assessment. To increase diagnostic confidence, it is recommended to introduce additional diagnostic and risk assessment methods aimed at a more personalized risk assessment in screening examinations in combination with or without PSA. There is no generally accepted strategy for PCa screening. Several risk-adapted screening strategies are currently being tested around the world, with a final evaluation of the effectiveness of these strategies expected in a few years.