Background: Prostate cancer (PCa) is the second most common cancerin the male population and represents a major health problem, especially in developed countries, where older men are more prevalent in the general population. Analyzing recent data for European countries, the incidence is highest in Northern and Western Europe (>200 per 100,000), while the rate is lower in Eastern and Southern Europe, but shows a continuous increase. Globally, about 450,000 Europeans are diagnosed with prostate cancer each year, and prostate cancer was the second most common cause of cancer-related deaths in 2018, when it was the cause of death for 107,000 men in Europe. Global data for BiH indicate that PCa is the second most common cancer in the male population, or the third leading cause of death in men due to cancer. Objective: The aim of this study was to analyze (PCa) how PCa screening is the most controversial topic regarding statements described in the urological literature searching most important biomedical on-line databases. Methods: Authors used descriptive method for this systematic study based on the published literature, summarized through meta-analysis, to show that screening was associated with an increase in PCa diagnosis. Results and Discussion: Most of autghors written about this topic and concluded that the greater detection of localized and less advanced PCa disease, but without benefits in the field of PCa specific survival and overall survival, overdiagnosis and overtreatment, leading to recommendations against systematic population screening in all countries, including Europe. The main diagnostic tools for diagnosing PCa are digitorectal examination (DRE), serum specific antigen concentration (PSA), transrectal ultrasonography (TRUS) and mp MRI, and the definitive diagnosis is based on pathohistological verification of cancer in prostate biopsy specimens or operative specimen. The indication for biopsy should be determined based on PSA levels and/or suspected DRE, depending on age, potential comorbidities and therapeutic consequences, and the indication for repeated biopsy is an increase or persistently elevated PSA, suspected DRE, atypical small acinar proliferation (ASAP), extensive high grade prostatic intraepithelial neoplasia (PIN) and positive multiparametric MRI of the prostate (PI-RADS ≥3). Conclusion: PCa volume assessment is based on DRE and PSA with the addition of multiparametric MRI, bone scan and CT, although there are new imaging modalities, such as PET/CT scan and Diffusion-weighted whole-body MRI. However, the cost-effectiveness of these new approaches needs to be further assessed. Given that COVID-19 has imposed other priorities on all health systems, we hope that the diagnosis of clinically significant prostate cancer and adequate treatment is not questionable at this time.
Key words: Keywords: prostate cancer, DRE, PSA, TRUS, prostate biopsy, CT, MRI, skeletal scintigraphy.
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