Risikoadaptierte Prostatakarzinomfrüherkennung 2.0 – Positionspapier der Deutschen Gesellschaft für Urologie 2024

Background and objective: 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 a concept for risk-adapted prostate cancer early detection. Materials and methods: Based on a literature review of current screening studies, an algorithm for PSA-based prostate cancer early detection was developed. Results: Risk-adapted prostate cancer screening involves PSA testing in the age group of 45–70 years, followed by PSA-based individual risk stratification and stepwise expansion of diagnostics through magnetic resonance imaging (MRI) to biopsy. While initially up to 2.6 million men will undergo PSA testing, a reduction in these initial examinations to fewer than 200,000 men per year will occur from year four onwards. Conclusions: 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.