Prostate Cancer Screening With PSA, Risk Calculator and Multiparametric MRI: a Pilot Study
Overview
- Phase
- N/A
- Intervention
- Urology visit with Risk Calculator and MRI
- Conditions
- Prostate Cancer
- Sponsor
- Fondazione del Piemonte per l'Oncologia
- Enrollment
- 4500
- Locations
- 1
- Primary Endpoint
- Detection rate of clinically significant prostate cancer (Gleason Group ≥2)
- Status
- Enrolling by Invitation
- Last Updated
- last month
Overview
Brief Summary
Prostate Cancer (PCa) is the second most frequently diagnosed tumour and the third most lethal among men in Europe. The lack of precise tools and examinations to precisely diagnose PCa has caused overtreatment of indolent and low-aggressive PCa, while in some other cases, with aggressive disease, diagnosis and treatment are dangerously delayed because cancer could be potentially missed. The present trial aims to study a new pathway to early diagnose PCa with Magnetic Resonance Imaging (MRI) to identify men who will not need treatment and those who will benefit from radical treatment, thus improving disease control and quality of life.
Detailed Description
Men aged 55-65 years with neither previous biopsy nor prostate diseases will be invited in the screening protocol and will perform an initial PSA test. Those cases with PSA ≥ 3 ng/ml will be invited to undergo a urologic examination with computed risk assessment and an MRI, which is a non-invasive test with high positive and negative predictive value in identifying clinically significant prostate cancer. Then, only men with medium-high risk of harbouring clinically significant prostate cancer will be invited to undergo a prostate biopsy to indentify cancer presence and its aggressiveness.
Investigators
Eligibility Criteria
Inclusion Criteria
- •age between 55-65 years;
- •asymptomatic or paucisymptomatic from a urological point of view;
- •no previous prostate biopsy;
- •living in the ASL TO5 (Piedmont, Italy);
- •signed written informed consent.
Exclusion Criteria
- •positive oncologic anamnesis for prostate cancer;
- •previous biopsy or prostate surgery;
- •previous radiotherapy of the pelvis;
- •any contraindication to MRI examination;
- •claustrophobic or uncollaborative subjects.
Arms & Interventions
Subjects with PSA ≥ 3 ng/ml
* Urologic examination * Risk calculation (ERSPC no.6) * Magnetic resonance imaging * (optional) biopsy
Intervention: Urology visit with Risk Calculator and MRI
Outcomes
Primary Outcomes
Detection rate of clinically significant prostate cancer (Gleason Group ≥2)
Time Frame: 24 months
No. of detected clinically significant prostate cancer with Gleason Group ≥ 2 over the total no. of men enrolled in the trial
Comparison of the detection rate of clinically significant prostate cancer with and without screening
Time Frame: 24 months
No. of detected clinically significant prostate cancer with Gleason Group ≥ 2 over the total no. of men enrolled in the trial compared to the same proportion of men calculated in the 2-year period before the introduction of the screening protocol
Verify that the detection rate of clinically significant prostate cancer with the screening strategy is not inferior to that of the Italian cohort in the ERSPC study
Time Frame: 24 months
No. of detected clinically significant prostate cancer with Gleason Group ≥ 2 over the total no. of men enrolled in the trial compared to the same proportion of men included in the Italian cohort of the ERSPC study screened using PSA only
Secondary Outcomes
- Changes in number of biopsy procedures(24 months)
- Assessment of positive and negative predictive values(24 months)