Risk-based XXXX screening.

@entity1 @entity263 @entity1486 @entity146
CONTEXT: Widespread mass screening of @entity263 ( @entity263 ) is not recommended because the balance between benefits and harms is still not well established. The achieved mortality reduction comes with considerable harm such as unnecessary biopsies, overdiagnoses, and overtreatment. Therefore, @entity1 stratification with regard to @entity263 risk and @entity146 is necessary to identify those @entity1 who are at risk and may actually benefit from early detection. OBJECTIVE: This review critically examines the current evidence regarding risk-based @entity263 screening. EVIDENCE ACQUISITION: A search of the literature was performed using the Medline database. Further studies were selected based on manual searches of reference lists and review articles. EVIDENCE SYNTHESIS: @entity1486 has been shown to be the single most significant predictive factor for identifying @entity1 at increased risk of developing @entity263 . Especially in @entity1 with no additional risk factors, @entity1486 alone provides an appropriate marker up to 30 yr into the future. After assessment of an early @entity1486 test, the screening frequency may be determined based on individualized risk. A limited list of additional factors such as age, comorbidity, prostate volume, family history, ethnicity, and previous biopsy status have been identified to modify risk and are important for consideration in routine practice. In @entity1 with a known @entity1486 , risk calculators may hold the promise of identifying those who are at increased risk of having @entity263 and are therefore candidates for biopsy. CONCLUSIONS: @entity1486 testing may serve as the foundation for a more risk-based assessment. However, the decision to undergo early @entity1486 testing should be a shared one between the @entity1 and his physician based on information balancing its advantages and disadvantages.
