Prostate Cancer Screening Research Articles

What does cancer screening have to do with tomato growing?

Cancer screening is considered to be a major strategy for combatting cancer. The United States Preventive Services Task Force (USPSTF) recommends screening for five cancers, but the strength of evidence about the effectiveness of screening is limited. To gain insights into the efficacy of early detection requires prospective, blinded, placebo-controlled clinical trials with decades of follow-up and inclusion of millions of participants. Recently, Bretthauer etal. estimated lifetime gained with cancer screening tests by using a meta-analysis of 18 large randomized clinical trials which included more than two million subjects. They asked if cancer screening tests are saving lives and how much life is extended due to commonly used cancer screening tests. Colorectal cancer screening with sigmoidoscopy prolonged lifetime by 110days, while fecal testing and mammography screening did not prolong life. A modest extension of 37days was noted for prostate cancer screening with prostate-specific antigen testing and 107days with lung cancer screening using computed tomography, but these estimates were not statistically significant. The authors concluded that current cancer screening strategies do not significantly prolong life. Based on these data, and the known biological behavior of some cancers, we hypothesized that the current strategies of treating cancer, after detection, could be modified to avoid the side effects of screening, which is a major determinant of the patient's overall survival.

The Whole-Body MRI Reporting and Data System Guidelines for Prostate Cancer (MET-RADS-P), Multiple Myeloma (MY-RADS), and Cancer Screening (ONCO-RADS)

Whole-body magnetic resonance imaging (WB-MRI) is being employed with increasing frequency to evaluate a broader spectrum of patients with diverse types of cancer and for cancer screening purposes. While clinical guidelines support its use, a standardized radiological approach is still lacking. To improve consistency in the acquisition, interpretation, and reporting of WB-MRI examinations, three reporting and data systems (RADSs) have been recently suggested: METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P), Myeloma Response Assessment and Diagnosis System (MY-RADS), and Oncologically Relevant Findings Reporting and Data System (ONCO-RADS). MET-RADS-P was developed to stage and monitor men with advanced prostate cancer using WB-MRI. It has emerged as a reliable imaging biomarker for predicting metastatic disease progression and assessing treatment response. MY-RADS was developed to stage and monitor patients with multiple myeloma using WB-MRI, emerging as a prognostic imaging biomarker. However, the evidence regarding inter-reader agreement for MY-RADS is currently limited. ONCO-RADS was developed to standardize the use of WB-MRI for cancer screening in individuals with cancer predisposition syndromes and in the general population. While initial findings are promising, the evidence supporting its use remains limited. To further validate and expand upon these promising preliminary findings, additional large-scale, prospective, multicenter studies are necessary.

Rethinking prostate cancer screening in transgender women

Introduction: Over the years, the number of people openly identifying as transgender has steadily increased, leading to a greater need for transgender-specific healthcare information. Among transgender women (TW), there remains a risk of prostate cancer since the prostate is not removed during gender-affirming hormone therapy (GAHT) or surgery; however, there is limited knowledge about prostate cancer screening in the transgender population. Although there are few reported cases of prostate cancer screening or prostate-specific antigen (PSA) testing in TW, the impact of hormone therapies on PSA levels is well-documented. Notably, GAHT for TW and hormone therapy for treating prostate cancer share similarities. Drawing on these similarities, we aimed to develop guidelines for baseline PSA levels and prostate cancer screening in TW. Methods: Through a systematic review, we examined the existing PubMed publications on PSA levels and prostate cancer screening in TW, as well as expected PSA levels in patients with prostate cancer undergoing hormone therapies. We also investigated other aspects considered for the diagnosis of prostate cancer. Given the limited research on TW, we also included relevant case studies. These publications and case reports were reviewed and analyzed to create a comprehensive overview of expected baseline PSA levels and prostate cancer screening guidelines for TW. Results: Currently, there are no established guidelines for PSA or prostate cancer screening in TW; however, these case studies indicated a range of PSA values from 3.3 to <100 ng/ml. Existing literature on expected PSA levels in prostate cancer patients undergoing hormone therapy shows a reduction in PSA of over 50% post-therapy. This evidence suggests that PSA values in TW presenting with prostate cancer may be lower than those observed in cisgender males with the disease. Conclusions: While TW exhibit lower prostate cancer incidence compared to cisgender men, the impact of hormone therapy on PSA levels presents significant challenges for screening and diagnosis. The parallels between PSA level reductions in TG women and cisgender men undergoing estrogen therapy highlight the need for revised screening protocols. Addressing these challenges through targeted research and personalized care approaches will be vital for improving prostate cancer management in transgender individuals.

Association between hormone therapy and glioma risk in US women: a cancer screening trial.

Gliomas are the most common primary brain tumors in adults, and the role of hormone therapy (HT) in their development remains controversial. This study with a cohort design aimed to investigate the association between HT use and glioma risk using the data from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. We analyzed data from 75,335 women, aged 50-78, who were enrolled between 1993 and 2001. The median follow-up period was 11.82 years. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the relationship between HT use and glioma risk, adjusting for various potential confounders. Over the follow-up period, 101 participants were diagnosed with glioma. After adjusting for relevant variables, there was no significant association between HT use and glioma risk (HR, 1.16; 95% CI, 0.75-1.81). Similarly, no significant associations were found when considering HT status or duration of use. However, in subgroup analysis by education, marital status, body mass index, oral contraceptive, hysterectomy, ovariectomy, ever been pregnant, age at menarche, and age at menopause, we found that a significant positive association was only observed in the group with at least college graduate (HR, 3.00; 95% CI, 1.02-8.84). The interaction effect for education was not significant (P = 0.056). Our findings suggest no overall link between HT use and glioma risk. Further research is needed to confirm these results.

Association of whole grain food consumption with lung cancer risk: a prospective cohort study

BackgroundWhether the intake of whole grain foods can protect against lung cancer is a long-standing question of considerable public health import, but the epidemiologic evidence has been limited. Therefore we aim to investigate the relationship between whole grain food consumption and lung cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort.MethodsDiet was assessed with a self-administered Diet History Questionnaire (DHQ) at baseline. All incident lung cancer cases were pathologically verified. Hazard ratios and 95% confidence intervals for lung cancer risk associated with whole grain food consumption were estimated by Cox proportional hazards regression.ResultsDuring a median follow-up of 12.2 years, a total of 1,706 incident lung cancer events occurred, including 1,473 (86.3%) cases of non-small cell lung cancer (NSCLC) and 233 (13.7%) of small cell lung cancer (SCLC). After multivariate adjustment, comparing the highest quarter of consumption of whole grain foods to the lowest quarter, a 16% lower rate (HR 0.84, 95% CI 0.73–0.98) of lung cancer risks and a 17% lower rate (HR 0.83, 95% CI 0.69–0.98) for NSCLC were found, but no significant difference was shown for SCLC (HR 0.95, 95% CI 0.63–1.44). These results were consistently observed after a large range of subgroup and sensitivity analyses. A linear dose-response pattern was shown for lung cancer, NSCLC, and SCLC (P for non-linearity > 0.05).ConclusionsIn this large prospective cohort study, whole grain food consumption was associated with reduced lung cancer and NSCLC. Our findings suggest a potential protective role of whole grain foods against lung cancer.

Development and Validation of a Predictive Model of Prostate Screening Compliance: A Nationwide Population-Based Study.

Prostate cancer (PCa) is the second most common cancer in men worldwide, with significant incidence and mortality, particularly in Mexico, where diagnosis at advanced stages is common. Early detection through screening methods such as digital rectal examination and prostate-specific antigen testing is essential to improve outcomes. Despite current efforts, compliance with prostate screening (PS) remains low due to several barriers. This study aims to develop and validate a predictive model for PCa screening compliance in Mexican men. Retrospective observational design with data from the Mexican Health and Aging Study (MHAS). Participants were men aged 50-69 from three cohorts: development/internal validation, temporal validation, and external validation. Key predictors were identified using relaxed Least Absolute Shrinkage and Selection Operator (LASSO) regression, and model performance was assessed using the area under the curve (AUC) from receiver operating characteristic (ROC) analyses, along with calibration and decision curve analysis (DCA). A web nomogram was also developed. The final model included seven key predictors. AUC values indicated good predictive performance: 0.783 for the training subgroup, 0.722 for the test subgroup, 0.748 for the time cohort, and 0.756 for the external cohort, with sensitivities of 73.5%. The DCA demonstrated the superior clinical utility of the model compared to the reference strategies. The predictive model developed for performance to PCa screening is robust across different cohorts and highlights critical factors influencing performance. The accompanying web-based nomogram enhances clinical applicability and supports interventions aimed at improving PCa screening rates among Mexican men.

Small Area Estimation of PSA Testing in US States and Counties.

In 2012, the US Preventive Services Task Force recommended against prostate cancer screening using the PSA test for all age groups. In 2018, the US Preventive Services Task Force's recommendation shifted from a "D" (not recommended) to a "C" (selectively offering PSA-based screening based on professional judgment and patient preferences) in men ages 55 to 69. Limited reliable county-level prostate cancer screening data are available for cancer surveillance purposes. Utilizing data from the National Health Interview Survey (NHIS) and Behavioral Risk Factor Surveillance System (BRFSS) collected in 2012 to 2019, state- and county-level small area models were developed for estimating PSA testing. Model diagnosis, internal validation, and external validation examining associations of PSA testing and prostate cancer incidence were conducted. Model-based estimates of PSA testing rates were produced for all US states and 3,142 counties for two data periods: 2012 to 2016 and 2018 to 2019. Geographic variations across counties were demonstrated through maps. Moderate positive correlations between PSA-based screening and prostate cancer incidence were observed, e.g., the state-level weighted Pearson's correlation coefficients were 0.5025 (P value = 0.0002) and 0.3691 (P value = 0.0077) for 2012 to 2016 and 2018 to 2019, respectively. These modeled estimates showed improved precision and adjusted for the differences between the BRFSS and NHIS. The approach of combining the NHIS and BRFSS utilized strengths of the larger sample size of the BRFSS and generally higher response rates and better household coverage from the NHIS. The resulting small area estimates offer a valuable resource for the cancer surveillance community, aiding in targeted interventions, decision making, and further research endeavors.

Ultrasound radiomics model based on grayscale transrectal ultrasound-guided biopsy for diagnosing prostate cancer and predicting distant metastasis.

A prostate ultrasound (US) imaging omics model was established to assess its effectiveness in diagnosing prostate cancer (PCa), predicting Gleason score (GS), and determining the likelihood of distant metastasis. US images of patients with prostate pathology confirmed by biopsy or surgery at our hospital were retrospectively analyzed. Regions of interest (ROI) segmentation, feature extraction, feature screening, and the construction and training of the radiomics model were performed. Area under the curve (AUC) for the magnetic resonance imaging Prostate Imaging Reporting and Data System (MRI PI-RADS) classification, radiomics alone, and radiomics combined with prostate-specific antigen (PSA) in diagnosing PCa were 70.74%, 71.13%, and 90.47%, respectively. AUCs for the MRI PI-RADS classification, radiomics alone, and radiomics combined with PSA in predicting the GS of PCa were 75.6%, 74.7%, and 88.9%, respectively. Furthermore, AUCs for MRI PI-RADS classification and radiomics alone in predicting distant metastasis of PCa were 66.7% and 90.8%, respectively. The combination of ultrasonic imaging omics and serum PSA significantly improves the efficiency of PCa diagnosis, GS prediction, and distant metastasis prediction. This method is an important tool for PCa screening and follow-up.

Insights of prostate diseases risk among patients with male pattern baldness: a mendelian randomized study.

Male pattern baldness (MPB) is commonly associated with prostate diseases, both of which can significantly impact men's quality of life. However, the relationship and causality between them remain unclear. In this study, we investigated the causal relationship between the two. Inverse variance weighting (IVW) was the primary Mendelian randomization method, with MR Egger, weighted median, and MRPRESSO as complements. Sensitivity analyses included Cochran's Q, MR Egger intercept, and MRPRESSO. MPB was found to be negatively correlated with prostate cancer (IVW: OR = 0.986, 95% CI = 0.974-0.999, P = 0.033). This causal relationship was further supported by the weighted median (OR = 0.981, 95% CI = 0.969-0.993, P = 0.002), MR-Egger (OR = 0.977, 95% CI = 0.960-0.994, P = 0.010), and MRPRESSO (OR = 0.986, 95% CI = 0.974-0.999, P = 0.037) methods. Additionally, the weighted median analysis indicated that MPB was positively correlated with benign prostatic hyperplasia (BPH) (OR = 1.027, 95% CI = 1.003-1.052, P = 0.024). Our findings suggest that genetically predicted MPB may reduce prostate cancer risk but increase the risk of benign prostatic hyperplasia. Timely prostate screening in patients with MPB could help prevent and manage prostate diseases.

Prostate cancer screening: Is it time for a new approach? A review article.

Prostate cancer screening has presented a challenge to clinicians. Although the implementation of screening tests such as prostate-specific antigen (PSA) and digital rectal exam (DRE) has had a significant impact on prostate-cancer-specific mortality, these traditional screening tests have a relatively poor positive predictive value of clinically significant prostate cancer (CSPC), leading to unnecessary biopsies and treatment with a host of potential complications. Fortunately, much research has been done to optimize prostate cancer screening. This includes the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which underwent a secondary analysis to identify an association between PSA level and CSPC, and the IP1-PROSTAGRAM Tri.

Positive associations between dietary potential acid load and renal cancer incidence and mortality: Results from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial.

To explore the relationships between dietary potential acid load and renal cancer (RC) incidence and mortality. A prospective cohort study involving 97,166 US. adults aged 55-74 years. Data utilized in this study were drawn from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). Dietary potential acid load was assessed by dietary acid load (DAL), potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores using a validated Diet History Questionnaire (DHQ). Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for RC incidence and mortality with adjustment for potential confounders. Restricted cubic spline (RCS) plots were utilized to reveal whether there were nonlinear associations between the DAL, PRAL, and NEAP scores and RC incidence and mortality. During a follow-up period of 859,907 and 1,467,573 person-years, 423 RC cases and 221 mortality cases were documented. DAL, PRAL, and NEAP scores were positively associated with RC incidence (DAL: HR 1.41; 95% CI 1.05, 1.90; P-trend=0.010; PRAL: HR 1.45; 95% CI 1.10, 1.91; P-trend=0.010; NEAP: HR 1.39; 95% CI 1.04, 1.85; P-trend=0.029). Similar associations were observed between DAL, PRAL, and NEAP scores and RC mortality. The RCS plots demonstrated a nonlinear association between DAL score and RC risk, while a linear association was observed between DAL score and RC mortality. Similar linear associations were found between PRAL and NEAP scores and RC incidence and mortality. A higher dietary potential acid load was associated with higher risk of RC incidence and mortality in American adults.

A plant-based diet index and all-cause and cause-specific mortality: a prospective study.

Background: A plant-based dietary pattern has been recently suggested to have health benefits. However, its relationship with mortality is not completely consistent in prior studies. We aimed to investigate whether a plant-based diet was associated with a lower death risk in a Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening study. Methods: We included 91 414 participants from the PLCO study. Dietary data were collected using a diet history questionnaire (DHQ). We used three plant-based diet indices including an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazard regression model. Results: During a median of 17.1 years of follow-up, we documented 19 456 deaths, including 5489 deaths from cardiovascular disease (CVD) and 6172 deaths from cancer. Comparing the highest versus lowest quintiles of the PDI, the multivariable-adjusted HR of all-cause mortality was 0.83 (95% CI 0.80-0.87, P for trend < 0.001). Those in the highest quintile of the PDI also had lower risks of CVD mortality (HR 0.87, 95% CI 0.80-0.95, P for trend < 0.001) and cancer mortality (HR 0.89, 95% CI 0.82-0.96, P for trend = 0.003) compared to those in the lowest quintile. Participants in the highest quintile of the hPDI had a decreased risk of all-cause and cause-specific mortality, whereas participants with the highest uPDI scores had an increased death risk. Conclusion: Greater adherence to a plant-based dietary pattern was significantly associated with lower all-cause and cause-specific mortality.

Surface-Based Ultrasound Scans for the Screening of Prostate Cancer.

Surface-based ultrasound (SUS) systems have undergone substantial improvement over the years in image quality, ease-of-use, and reduction in size. Their ability to image organs non-invasively makes them a prime technology for the diagnosis and monitoring of various diseases and conditions. An example is the screening/risk- stratification of prostate cancer (PCa) using prostate-specific antigen density (PSAD). Current literature predominantly focuses on prostate volume (PV) estimation techniques that make use of magnetic resonance imaging (MRI) or transrectal ultrasound (TRUS) imaging, while SUS techniques are largely overlooked. If a reliable SUS PCa screening method can be introduced, patients may be able to forgo unnecessary MRI or TRUS scans. Such a screening procedure could be introduced into standard primary care settings with point-of-care ultrasound systems available at a fraction of the cost of their larger hospital counterparts. This review analyses whether literature suggests it is possible to use SUS-derived PV in the calculation of PSAD.

Development and Validation of a Deep Learning Model Based on MRI and Clinical Characteristics to Predict Risk of Prostate Cancer Progression.

Purpose To validate a deep learning (DL) model for predicting the risk of prostate cancer (PCa) progression based on MRI and clinical parameters and compare it with established models. Materials and Methods This retrospective study included 1607 MRI scans of 1143 male patients (median age, 64 years; IQR, 59-68 years) undergoing MRI for suspicion of clinically significant PCa (csPCa) (International Society of Urological Pathology grade > 1) between January 2012 and May 2022 who were negative for csPCa at baseline MRI. A DL model was developed using baseline MRI and clinical parameters (age, prostate-specific antigen [PSA] level, PSA density, and prostate volume) to predict the time to PCa progression (defined as csPCa diagnosis at follow-up). Internal and external testing was performed. The model's ability to predict progression to csPCa was assessed by Cox regression analyses. Predictive performance of the DL model up to 5 years after baseline MRI in comparison with the European Randomized Study of Screening for Prostate Cancer (ERSPC) future-risk calculator, Prostate Cancer Prevention Trial (PCPT) risk calculator, and Prostate Imaging Reporting and Data System (PI-RADS) was assessed using the Harrell C-index. Optimized follow-up intervals were derived from Kaplan-Meier curves. Results DL scores predicted csPCa progression (internal cohort: hazard ratio [HR], 1.97 [95% CI: 1.61, 2.41; P < .001]; external cohort: HR, 1.32 [95% CI: 1.14, 1.55; P < .001]). The model identified a subgroup of patients (approximately 20%) with risks for csPCa of 3% or less, 8% or less, and 18% or less after 1-, 2-, and 4-year follow-up, respectively. DL scores had a C-index of 0.68 (95% CI: 0.63, 0.74) at internal testing and 0.56 (95% CI: 0.51, 0.61) at external testing, outperforming ERSPC and PCPT (both P < .001) at internal testing. Conclusion The DL model accurately predicted PCa progression and provided improved risk estimations, demonstrating its ability to aid in personalized follow-up for low-risk PCa. Keywords: MRI, Prostate Cancer, Deep Learning Supplemental material is available for this article. ©RSNA, 2025.

IMPORTANT FACTORS INFLUENCING PROSTATE CANCER SCREENING AMONG INDIGENOUS MEN

Abstract Although there exists mounting evidence of systemic barriers to prostate cancer screening (PCS) among Indigenous peoples, there is a limited understanding of the individual-level barriers to PCS. This study examined how well predisposing, need, and enabling factors predict receipt of a PCS test among Indigenous men. This cross-sectional study recruited a total of 191 Indigenous men aged 40 and above, following the recommendation of the American Cancer Society by using the purposive sampling method in 2014. The study’s dependent variable was the receipt of a PCS. Independent variables included three predisposing, two need, and five enabling factors. Participants’ mean age was 51.58 years, ranging from 40 to 95, and 33.3% were married. The hierarchical logistic regression showed that married participants were 3.82 times more likely than those who never married to receive a PCS. Participants with a personal cancer history were 11.84 times more likely than those without a personal cancer history to receive a PCS. Participants who reported having access to medical care were 9.14 times more likely than those without access to medical care to receive a PCS. Additionally, participants who had heard about the prostate cancer exam were 21.44 times more likely than those who had not heard about the prostate cancer exam to receive a PCS. Social work practitioners or health care providers need to consider developing and providing appropriate prostate cancer prevention programs, family-based intervention programs, a support system for selecting an appropriate place for medical care, and prostate cancer screening education and assistance programs.

Prevalence of prostate cancer and its grade group stage at diagnosis in patients treated with prostatectomy in rural south western Uganda

BackgroundProstate cancer is the most frequently diagnosed cancer among men in the world. Uganda and Zimbabwe have been reported to have highest incidence rates of prostate cancer in sub-Saharan Africa. There are no urologists and no prostate cancer diagnostic facilities in rural communities in south western Uganda. Men with lower urinary tract symptoms are treated with prostatectomy by midlevel healthcare workers and general surgeons without prior prostate cancer screening. Histological diagnosis relies on the prostate tissue retrieved during surgery and the results may take several months. Prostate cancer care in southwestern Uganda remains uncoordinated and has not been documented before. This study aimed to establish and document the burden of prostate cancer in rural southwestern Uganda as a basis for further research.MethodsThis was a retrospective study conducted in hospitals in rural southwestern Uganda. We used hospital records as primary source of data. Histology results of patients treated with prostatectomy during the five-year period (2019–2023) were retrieved and data extracted for analysis. 1013 patients were included in the study. Univariate data analysis was done with STATA version 17.0. The study received ethics clearance for Kabale university REC and Uganda National council of Science and Technology.ResultsThe average age of patients in this study was 70.6 year (range 54–102 years). Prostate cancer was present in 232 (22.9%) patients. Seventeen (7.3%) patients with prostate cancer were below sixty years. Most (75.4%) of the patients with prostate cancer in this study had low to intermediate risk disease. Perineural tumor infiltration was present in 28.9% of prostate cancer patients.ConclusionMore than 1 in 5 men (22.9%) with lower urinary tract symptoms treated with prostatectomy in the study period in southwestern Uganda had prostate cancer. Majority of patients (75.4%) had low to intermediate risk disease. These findings highlight the urgent need for systematic improvements in prostate cancer care, including sensitization of both health workers and the general population, establishment of early screening and regional diagnostic and treatment facilities to enhance patient outcomes in resource -limited rural communities in Uganda.Clinical trial numberNot applicable.

Important factors influencing prostate cancer screening among indigenous men

ABSTRACT Indigenous men diagnosed with prostate cancer have the lowest five-year survival rates across all racial/ethnic groups; at least partially due to lower rates of screening and limited access to treatment. This study examined factors correlating with receipt of prostate cancer screenings among 191 Indigenous men residing in the Northern Plains using a convenience sampling method. Results of the hierarchical logistic regression revealed that participants who reported being married, who had personal cancer history, who reported having access to medical care, and/or who had knowledge related to prostate cancer exams were more likely to have the receipt of a prostate cancer screening. Findings indicate the necessity of developing appropriate prostate cancer prevention programs, family-based intervention programs, a support system for selecting an appropriate place for medical care, and prostate cancer screening education and assistance programs for this population.

Genetic variants of FER and SULF1 in the fibroblast-related genes are associated with non-small-cell lung cancer survival.

Fibroblasts are important components in the tumor microenvironment and can affect tumor progression and metastasis. However, the roles of genetic variants of the fibroblast-related genes (FRGs) in the prognosis of non-small-cell lung cancer (NSCLC) patients have not been reported. Therefore, we investigated the associations between 26,544 single nucleotide polymorphisms (SNPs) in 291 FRGs and survival of NSCLC patients from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. In Cox regression multivariable analysis, we found that 661 SNPs were associated with NSCLC overall survival (OS). Then we validated these SNPs in another independent replication dataset of 984 patients from the Harvard Lung Cancer Susceptibility (HLCS) Study. Finally, we identified two independent SNPs (i.e., FER rs7716388 A>G and SULF1 rs11785839 G>C) that remained significantly associated with NSCLC survival with hazards ratios (HRs) of 0.87 (95% confidence interval [CI] = 0.77-0.98, p = 0.018) and 0.88 (95% CI = 0.79-0.99, p = 0.033), respectively. Combined analysis for these two SNPs showed that the number of protective alleles was associated with better OS and disease-specific survival. Expression quantitative trait loci analysis indicated that the FER rs7716388 G allele was associated with the up-regulation of FER mRNA expression levels in lung tissue. Our results indicated that these two functional SNPs in the FRGs may be prognostic biomarkers for the prognosis of NSCLC patients, and the possible mechanism may be through modulating the expression of their corresponding genes.

Assessment of prostate cancer awareness and screening among men in Gombe State, Nigeria

Assessment of prostate cancer awareness and screening among men in Gombe State, Nigeria

Perspectives of clinicians and screening candidates on shared decision-making in prostate cancer screening with the prostate-specific antigen (PSA) test: a qualitative study (PROSHADE study)

ObjectiveThe objective of this study is to analyse the perspectives of screening candidates and healthcare professionals on shared decision-making (SDM) in prostate cancer (PCa) screening using the prostate-specific antigen (PSA) test.DesignDescriptive qualitative study (May–December 2022): six face-to-face focus groups and four semistructured interviews were conducted, transcribed verbatim and thematically analysed using ATLAS.ti software.SettingData were obtained as part of the project PROSHADE (Decision Aid for Promoting Shared Decision Making in Opportunistic Screening for Prostate Cancer) to develop a tool for SDM in PCa screening with PSA testing in Spain.ParticipantsA total of 27 screening candidates (three groups of men: 40–50 years old; 51–60 years old and 61–80 years old), 25 primary care professionals (one group of eight nurses and two groups of physicians: one with more and one with less than 10 years of experience), and four urologists. Focus groups for patients and healthcare professionals were conducted separately.Main outcome measuresParticipants' perceptions of shared decision-making related to PSA opportunistic screening, including their understanding, preferences, and attitudes.ResultsThree themes were generated: (1) perceptions of SDM, (2) perceptions of PSA testing and (3) perceptions of SDM regarding PCa screening. Theme 1: screening candidates valued SDM when it included clear information and empowered them. There was consensus with primary care health professionals on this point, although their knowledge and implementation of SDM varied. Theme 2: candidates were divided on PSA testing; some trusted it for early detection, while others expressed scepticism due to concerns about false positives and invasive procedures, reflecting gaps in accessible information. Theme 3: professionals across primary and specialised care stressed the need for standardised SDM protocols. Primary care physicians were particularly concerned that PSA decisions align with scientific evidence and urologists recognised SDM as valuable in PSA testing only if it was adequately explained to each patient. Barriers to implementing SDM included insufficient coordination across care levels, lack of consensus-driven protocols and limited clinical time.ConclusionsWhile patients expect comprehensive information, primarily based on practice to achieve empowerment, healthcare professionals face obstacles such as limited time and insufficient coordination between primary care and urology. All stakeholders agree on the importance of evidence-based tools to reinforce effective SDM and enhance collaboration across urologists and primary care in the context of PSA testing.