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@ARTICLE{Albers:303643,
author = {P. Albers$^*$ and T. Franiel and T. Kötter and G.
Kristiansen and K. Herrmann$^*$ and T. Wiegel},
title = {{T}he {E}arly {D}etection, {D}iagnostic {E}valuation, and
{L}ocal {T}reatment of {P}rostate {C}ancer: {A} {P}aradigm
{S}hift.},
journal = {Deutsches Ärzteblatt international},
volume = {122},
number = {15},
issn = {1866-0452},
address = {Köln},
publisher = {Dt. Ärzte-Verl.},
reportid = {DKFZ-2025-01707},
pages = {420-426},
year = {2025},
note = {#EA:C130# / 2025 Jul 5;122(15):420-426},
abstract = {Approximately 75 000 men receive a diagnosis of prostate
cancer in Germany each year. New data on the early
detection, diagnostic evaluation, and treatment of prostate
cancer provide the basis for a paradigm shift in the
management of locally confined prostate cancer.This
narrative review is based on the systematic literature
search that was carried out for the 2025 update of the
German clinical practice guideline on prostate
cancer.Risk-adapted early detection is now recommended. This
involves the measurement of a baseline PSA value at age 45
whose magnitude determines the interval of follow-up
testing: once every 5 years for baseline values below 1.5
ng/mL, and once every two years for baseline values between
1.5 and 3 ng/mL. Patients with PSA levels above 3 ng/mL
should undergo a repeat PSA test and, if these levels are
confirmed, receive a urological risk assessment including
prostatic volume, family history, and past medical history.
High risk patients should undergo magnetic resonance imaging
(MRI) and, if necessary, prostate biopsy. This new PSA-MRI
algorithm increases accuracy in detecting clinically
significant prostate cancers, enabling the previously
recommended annual testing and digital rectal examination to
be avoided. Another novelty is that the indication for an
active surveillance strategy for men with low-risk prostate
cancer has been expanded to ISUP grade group 1 and 2 cancers
with favorable risk.The need for high-quality diagnostic
testing, including MRI, with broad geographic coverage will
be a major challenge to the health care system, especially
with regard to accessibility. Patients can be expected to
benefit greatly from the new PSA-MRI algorithm, as it
eliminates unnecessary diagnostic testing and treatment
while enabling necessary treatment to be initiated earlier
and therefore with fewer side effects.},
subtyp = {Review Article},
cin = {C130 / ED01},
ddc = {610},
cid = {I:(DE-He78)C130-20160331 / I:(DE-He78)ED01-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40536418},
doi = {10.3238/arztebl.m2025.0099},
url = {https://inrepo02.dkfz.de/record/303643},
}