Journal Article

DKFZ-2026-01759

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Confirmation of Prostate-specific Antigen (PSA) Values Improves Prostate Cancer Screening in Early Middle-Aged Men - Data from the PROBASE Trial.

Krilaviciute, A. (First author)DKFZ* ; Becker, N.DKFZ* ; Carlsson, S. V.DKFZ* ; Kaaks, R.DKFZ* ; Seibold, P.DKFZ* ; Lakes, J. ; Al-Monajjed, R.DKFZ* ; Kuczyk, M. ; Harke, N. N. ; Kanaan, M. R. ; Debus, J. ; Grott, C. A. ; Liermann, J. ; Gschwend, J. E. ; Herkommer, K. ; Göldner, V. A. ; Kristiansen, G. ; Antoch, G. ; Schimmöller, L. ; Arsov, C. ; Hadaschik, B. ; Albers, P. (Last author)DKFZ*

2026
Elsevier Science Amsterdam [u.a.]

Abstract: To assess the effectiveness of a confirmatory prostate-specific antigen (PSA) test as a safeguard against unnecessary work-up and to improve the specificity of prostate cancer (PCa) screening.Overall, 72,157 PSA values corresponding to screening rounds at age 45-55 yr in the PROBASE trial were analyzed. Positive PSA tests were reported as the proportion of men with an initial or confirmatory PSA ≥3 ng/ml. The cumulative PCa number over 6 yr was described for men with and without confirmatory PSA decrease at baseline screening (age 45 yr). Sankey diagrams were plotted to illustrate changes in PSA values over 10 yr with 2-yearly PSA screening.Overall, 2782 initial PSAs and 2702 (97%) confirmatory PSAs were observed. A total of 38% (95% confidence interval [CI] 36, 40) of men with initial PSA ≥3 ng/ml had a PSA <3 ng/ml at confirmatory testing. Estimates differed by age and screening round: 46% (95% CI 41, 51) in 45-yr-olds and 34% (95% CI 31, 38) in 50-yr-olds. PSA was repeated at a median of 28 d (interquartile range [IQR] 20, 39). Median change was -0.5 ng/ml (IQR -1.3, +0.06). PCa risk at 6 yr was 33% in those with confirmed PSA and 7.0% in those with PSA decrease at age 45 yr (risk ratio 4.68, CI 2.55, 8.59). The main limitation is incomplete biopsy information.PSA elevations in early-middle-aged men are common and PSA should be confirmed before initiating diagnostic work-up in a screening setting.Repeating PSA before initiating diagnostic work-up reduces immediate further diagnostics.

Keyword(s): Confirmatory PSA ; PSA ; Prostate cancer ; Prostate specific antigen ; Repeat PSA ; Screening

Note: #EA:C130#LA:C130# / epub

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Contributing Institute(s):

1. Personalisierte Früherkennung des Prostatakarzinoms (C130)
2. Erimitus im DKFZ (Z999)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2026

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 20 ; JCR ; National-Konsortium ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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