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European Urology Aug 2023Prostate cancer (PCa) is one of the most common cancers worldwide. Understanding the epidemiology and risk factors of the disease is paramount to improve primary and... (Review)
Review
CONTEXT
Prostate cancer (PCa) is one of the most common cancers worldwide. Understanding the epidemiology and risk factors of the disease is paramount to improve primary and secondary prevention strategies.
OBJECTIVE
To systematically review and summarize the current evidence on the descriptive epidemiology, large screening studies, diagnostic techniques, and risk factors of PCa.
EVIDENCE ACQUISITION
PCa incidence and mortality rates for 2020 were obtained from the GLOBOCAN database of the International Agency for Research on Cancer. A systematic search was performed in July 2022 using PubMed/MEDLINE and EMBASE biomedical databases. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and was registered in PROSPERO (CRD42022359728).
EVIDENCE SYNTHESIS
Globally, PCa is the second most common cancer, with the highest incidence in North and South America, Europe, Australia, and the Caribbean. Risk factors include age, family history, and genetic predisposition. Additional factors may include smoking, diet, physical activity, specific medications, and occupational factors. As PCa screening has become more accepted, newer approaches such as magnetic resonance imaging (MRI) and biomarkers have been implemented to identify patients who are likely to harbor significant tumors. Limitations of this review include the evidence being derived from meta-analyses of mostly retrospective studies.
CONCLUSIONS
PCa remains the second most common cancer among men worldwide. PCa screening is gaining acceptance and will likely reduce PCa mortality at the cost of overdiagnosis and overtreatment. Increasing use of MRI and biomarkers for the detection of PCa may mitigate some of the negative consequences of screening.
PATIENT SUMMARY
Prostate cancer (PCa) remains the second most common cancer among men, and screening for PCa is likely to increase in the future. Improved diagnostic techniques can help reduce the number of men who need to be diagnosed and treated to save one life. Avoidable risk factors for PCa may include factors such as smoking, diet, physical activity, specific medications, and certain occupations.
Topics: Male; Humans; Retrospective Studies; Prostatic Neoplasms; Prostate; Risk Factors; Prostate-Specific Antigen
PubMed: 37202314
DOI: 10.1016/j.eururo.2023.04.021 -
Journal of the National Comprehensive... Oct 2023The NCCN Guidelines for Prostate Cancer provide a framework on which to base decisions regarding the workup of patients with prostate cancer, risk stratification and...
The NCCN Guidelines for Prostate Cancer provide a framework on which to base decisions regarding the workup of patients with prostate cancer, risk stratification and management of localized disease, post-treatment monitoring, and treatment of recurrence and advanced disease. The Guidelines sections included in this article focus on the management of metastatic castration-sensitive disease, nonmetastatic castration-resistant prostate cancer (CRPC), and metastatic CRPC (mCRPC). Androgen deprivation therapy (ADT) with treatment intensification is strongly recommended for patients with metastatic castration-sensitive prostate cancer. For patients with nonmetastatic CRPC, ADT is continued with or without the addition of certain secondary hormone therapies depending on prostate-specific antigen doubling time. In the mCRPC setting, ADT is continued with the sequential addition of certain secondary hormone therapies, chemotherapies, immunotherapies, radiopharmaceuticals, and/or targeted therapies. The NCCN Prostate Cancer Panel emphasizes a shared decision-making approach in all disease settings based on patient preferences, prior treatment exposures, the presence or absence of visceral disease, symptoms, and potential side effects.
Topics: Humans; Male; Androgen Antagonists; Hormones; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant
PubMed: 37856213
DOI: 10.6004/jnccn.2023.0050 -
International Journal of Molecular... Aug 2023Epidemiological data highlight prostate cancer as a significant global health issue, with high incidence and substantial impact on patients' quality of life. The... (Review)
Review
Epidemiological data highlight prostate cancer as a significant global health issue, with high incidence and substantial impact on patients' quality of life. The prevalence of this disease is associated with various factors, including age, heredity, and race. Recent research in prostate cancer genetics has identified several genetic variants that may be associated with an increased risk of developing the disease. However, despite the significance of these findings, genetic markers for prostate cancer are not currently utilized in clinical practice as reliable indicators of the disease. In addition to genetics, epigenetic alterations also play a crucial role in prostate cancer development. Aberrant DNA methylation, changes in chromatin structure, and microRNA (miRNA) expression are major epigenetic events that influence oncogenesis. Existing markers for prostate cancer, such as prostate-specific antigen (PSA), have limitations in terms of sensitivity and specificity. The cost of testing, follow-up procedures, and treatment for false-positive results and overdiagnosis contributes to the overall healthcare expenditure. Improving the effectiveness of prostate cancer diagnosis and prognosis requires either narrowing the risk group by identifying new genetic factors or enhancing the sensitivity and specificity of existing markers. Immunological biomarkers (both circulating and intra-tumoral), including markers of immune response and immune dysfunction, represent a potentially useful area of research for enhancing the diagnosis and prognosis of prostate cancer. Our review emphasizes the need for developing novel immunological biomarkers to improve the diagnosis, prognosis, and management of prostate cancer. We highlight the most recent achievements in the identification of biomarkers provided by circulating monocytes and tumor-associated macrophages (TAMs). We highlight that monocyte-derived and TAM-derived biomarkers can enable to establish the missing links between genetic predisposition, hormonal metabolism and immune responses in prostate cancer.
Topics: Male; Humans; Quality of Life; Prostatic Neoplasms; Biomarkers; Prostate-Specific Antigen; Epigenesis, Genetic
PubMed: 37628978
DOI: 10.3390/ijms241612797 -
The Journal of Urology Jul 2023The summary presented herein covers recommendations on the early detection of prostate cancer and provides a framework to facilitate clinical decision-making in the...
PURPOSE
The summary presented herein covers recommendations on the early detection of prostate cancer and provides a framework to facilitate clinical decision-making in the implementation of prostate cancer screening, biopsy, and follow-up. This is Part I of a two-part series that focuses on prostate cancer screening. Please refer to Part II for discussion of initial and repeat biopsies as well as biopsy technique.
MATERIALS AND METHODS
The systematic review utilized to inform this guideline was conducted by an independent methodological consultant. The systematic review was based on searches in Ovid MEDLINE and Embase and Cochrane Database of Systematic Reviews (January 1, 2000-November 21, 2022). Searches were supplemented by reviewing reference lists of relevant articles.
RESULTS
The Early Detection of Prostate Cancer Panel developed evidence- and consensus-based guideline statements to provide guidance in prostate cancer screening, initial and repeat biopsy, and biopsy technique.
CONCLUSIONS
Prostate-specific antigen (PSA)-based prostate cancer screening in combination with shared decision-making (SDM) is recommended. Current data regarding risk from population-based cohorts provide a basis for longer screening intervals and tailored screening, and the use of available online risk calculators is encouraged.
Topics: Male; Humans; Prostatic Neoplasms; Prostate-Specific Antigen; Early Detection of Cancer; Systematic Reviews as Topic; Biopsy; Mass Screening
PubMed: 37096582
DOI: 10.1097/JU.0000000000003491 -
The Journal of Urology Aug 2023
Topics: Male; Humans; Urology; Prostatic Neoplasms; Medical Oncology; Urologic Neoplasms
PubMed: 37199093
DOI: 10.1097/JU.0000000000003541 -
Cancer Jan 2024
Topics: Male; Humans; Prostatic Neoplasms; Prostate-Specific Antigen
PubMed: 37927174
DOI: 10.1002/cncr.35032 -
Prostate Cancer and Prostatic Diseases Jun 2024
Topics: Humans; Male; Prostatic Neoplasms; Prostatic Diseases
PubMed: 38263282
DOI: 10.1038/s41391-024-00790-7 -
The Urologic Clinics of North America Feb 2024Artificial intelligence (AI) has the potential to transform pathologic diagnosis and cancer patient management as a predictive and prognostic biomarker. AI-based systems... (Review)
Review
Artificial intelligence (AI) has the potential to transform pathologic diagnosis and cancer patient management as a predictive and prognostic biomarker. AI-based systems can be used to examine digitally scanned histopathology slides and differentiate benign from malignant cells and low from high grade. Deep learning models can analyze patient data from individual or multimodal combinations and identify patterns to be used to predict the response to different therapeutic options, the risk of recurrence or progression, and the prognosis of the newly diagnosed patient. AI-based models will improve treatment planning for patients with prostate cancer and improve the efficiency and cost-effectiveness of the pathology laboratory.
Topics: Male; Humans; Artificial Intelligence; Prostatic Neoplasms
PubMed: 37945099
DOI: 10.1016/j.ucl.2023.06.001 -
The Urologic Clinics of North America Feb 2024Artificial intelligence (AI) is revolutionizing prostate cancer genomics research. By leveraging machine learning and deep learning algorithms, researchers can rapidly... (Review)
Review
Artificial intelligence (AI) is revolutionizing prostate cancer genomics research. By leveraging machine learning and deep learning algorithms, researchers can rapidly analyze vast genomic datasets to identify patterns and correlations that may be missed by traditional methods. These AI-driven insights can lead to the discovery of novel biomarkers, enhance the accuracy of diagnosis, and predict disease progression and treatment response. As such, AI is becoming an indispensable tool in the pursuit of personalized medicine for prostate cancer.
Topics: Male; Humans; Artificial Intelligence; Algorithms; Genomics; Machine Learning; Prostatic Neoplasms
PubMed: 37945100
DOI: 10.1016/j.ucl.2023.06.006 -
Clinics in Laboratory Medicine Jun 2024Molecular profiling studies have shed new light on the complex biology of prostate cancer. Genomic studies have highlighted that structural rearrangements are among the... (Review)
Review
Molecular profiling studies have shed new light on the complex biology of prostate cancer. Genomic studies have highlighted that structural rearrangements are among the most common recurrent alterations. In addition, both germline and somatic mutations in DNA repair genes are enriched in patients with advanced disease. Primary prostate cancer has long been known to be multifocal, but recent studies demonstrate that a large fraction of prostate cancer shows evidence of multiclonality, suggesting that genetically distinct, independently arising tumor clones coexist. Metastatic prostate cancer shows a high level of morphologic and molecular diversity, which is associated with resistance to systemic therapies. The resulting high level of intratumoral heterogeneity has important implications for diagnosis and poses major challenges for the implementation of molecular studies. Here we provide a concise review of the molecular pathology of prostate cancer, highlight clinically relevant alterations, and discuss opportunities for molecular testing.
Topics: Humans; Male; Mutation; Prostatic Neoplasms; Prostate
PubMed: 38821639
DOI: 10.1016/j.cll.2023.08.003