Abstract
Despite the proven effectiveness of organized PSA-based screening in reducing prostate cancer-related mortality, there is currently no program in Germany covered by statutory health insurance. In accordance with the EU Council Decision (2022/0290(NLE)), the German Society of Urology (DGU) has developed aconcept for risk-adapted prostate cancer early detection. Based on aliterature review of current screening studies, an algorithm for PSA-based prostate cancer early detection was developed. Risk-adapted prostate cancer screening involves PSA testing in the age group of 45-70years, followed by PSA-based individual risk stratification and stepwise expansion of diagnostics through magnetic resonance imaging (MRI) to biopsy. While initially up to 2.6million men will undergo PSA testing, areduction in these initial examinations to fewer than 200,000 men per year will occur from year four onwards. The presented algorithm provides clear recommendations for risk-adapted PSA-based early detection for prostate cancer for urologists and patients. The goal is to improve diagnosis of clinically significant prostate cancer, while reducing overdiagnosis and overtreatment.
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