MRI screening and targeted biopsies could potentially cut prostate cancer overdiagnosis in half

MRI screening for prostate cancer and a targeted biopsy strategy could potentially cut prostate cancer overdiagnosis in half, according to a new analysis released Friday.

Most countries do not have nationwide prostate screening programs, with current efforts based on prostate specific antigen (PSA) testing being prone to unnecessary biopsies and other problems. Magnetic resonance imaging has shown promise as a first-line tool in the fight against a disease that is expected to kill 34,000 people this year in the United States alone. And now new results in the New England Journal of Medicine add further evidence of its usefulness.

“Our results from a large randomized study show that modern methods of screening for prostate cancer maintain the benefits of screening, while dramatically reducing the risks. This addresses the biggest barrier to introducing screening to the ‘nationwide,’ author Tobias Nordström, associate professor of urology with the Karolinska Institute in Sweden, said in a statement.

To reach their conclusions, the scientists conducted a population-based trial of screening for prostate cancer in men aged 50 to 74. Participants with PSA levels above a certain threshold were randomized to undergo biopsy or MRI with targeted biopsy, if imaging suggested prostate cancer. In total, nearly 13,000 men signed up, while 1,532 met study criteria based on their PSA and Stockholm3 test, a risk prediction model using various factors to predict the likelihood of developing the disease.