Editing CUA: Prostate Cancer Screening (2017) (section)

== Answers ==

# As per the CUA Guidelines on PCa screening, who should be offered screening?
#* Men with life expectancy >10 years
# When should screening be started?
#* Age 50, age 45 if increased risk
# What is the recommended frequency of screening?
## Based on PSA level
##* <1 – every 4 years
##* 1 – 3 every 2 years
##* >3 discretion of urologist
# What is the role of DRE in prostate cancer screening?
#* Although the added utility of DRE in addition to PSA is controversial, DRE
# When should screening be stopped?
## PSA <1 and age 60
## Age 70
## Life expectancy < 10 years
# Describe the PROMIS trial
#* The objective of PROMIS was to compare the accuracy of mpMRI with TRUS biopsy to determine the utility of mpMRI as a triage test to decide which men with an elevated PSA may be able to avoid biopsy. The study included 576 men with clinical suspicious of prostate cancer that underwent mpMRI followed by standard TRUS biopsy with template prostate mapping biopsy as gold standard reference. The study found that mpMRI had moderate sensitivity but poor specificity for clinically significant prostate cancer.
# How do the CUA guidelines use data from PROMIS to recommend the role of mpMRI in the diagnosis of prostate cancer?
#* mpMRI should not be used in biopsy niave patients, should be reserved for patients with negative biopsy
# What PSA isoforms are included in the prostate health index score?
#* Total PSA, free PSA, -2proPSA