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Prostate Cancer Screening: a Pilot Study

Not Applicable
Conditions
Prostate Cancer
Interventions
Diagnostic Test: Urology visit with Risk Calculator and MRI
Registration Number
NCT06238661
Lead Sponsor
Fondazione del Piemonte per l'Oncologia
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.

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
Male
Target Recruitment
4500
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.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Subjects with PSA ≥ 3 ng/mlUrology visit with Risk Calculator and MRI* Urologic examination * Risk calculation (ERSPC no.6) * Magnetic resonance imaging * (optional) biopsy
Primary Outcome Measures
NameTimeMethod
Detection rate of clinically significant prostate cancer (Gleason Group ≥2)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 screening24 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 study24 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 Outcome Measures
NameTimeMethod
Changes in number of biopsy procedures24 months

Estimation of the number of biopsy that could be avoided using the new screening strategy compared to the use of PSA only.

Assessment of positive and negative predictive values24 months

Definition of positive and negative predictive values of the proposed screening strategy and comparison with those obtained in the ERSPC screening study with PSA only

Trial Locations

Locations (1)

Fondazione del Piemonte per l'Oncologia

🇮🇹

Candiolo, Italy

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