SIU-ICUD: Screening and Early Detection of Prostate Cancer

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The Manuscript is a review about prostate cancer and screening/early detection. The subject is interesting and may be suitable for publication after some minor revisions, such as the last part (Author Contributions, Funding, International Review Board Statement...) which is not complete;

Comments on the Quality of English Language

Minor English editing is required, such as correcting typing errors or make some long sentences shorter.

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The manuscript is interesting but some points could be improved

1. The Authors in their revision of literature should report also the case findings protocols used in recent years for the early diagnosis of PCa reporting advantages ad limits (Aragona F, et al: Incidence of prostate cancer in Sicily: results of a multicenter case-findings protocol. Eur Urol. 2005 May;47(5):569-74. doi: 10.1016/j.eururo.2004.11.007. Epub 2005 Jan 15. PMID: 15826745.

2. The use of mpMRI as traige test to perform prostate biopsy increases the diagnosis of csPCa but is associated with a 15-20% of false negative rate for csPCa; in addition, an emergent risk using only targeted cores omitting systematic cores is the upgrading of biopsy histology and downgrading at radical prostatectomy with conseguent risk of overtreatment. The Authors should be informed of risk and advantages. 

3. The Authors should report the role of genetic markers to select men at high risk for PCa who need early evaluation (Pepe P et a:  PCA3 score and prostate cancer diagnosis at repeated saturation biopsy. Which cut-off: 20 or 35? Int Braz J Urol. 2012 Jul-Aug;38(4):489-95). In detail, the Authors should report the screenig protocol for patients with BRCA mutations. 

4. The Authors should conclude reporting clearly  andvantages and risk of screening protocols

Author Response

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Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

This is a nice narrative review about state of art and future directions about prostate cancer screening.  I would only add something about the role of genetics in identifying the population at higher risk of developing PC, the need for tailored screening and the possible role of bi-parametric magnetic resonance 

Author Response

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Reviewer 4 Report

Comments and Suggestions for Authors

In this manuscript, authors performed a narrative review on screening and early detection of prostate cancer.

Manuscript is interesting, however some points should be clarified.

1)    I would add characteristics of the paper in the title.such as : “a narrative review.”

2)    I would underline necessity of screening for prostate cancer, not available in some countries just Italy

3)    I would add some actual references on topic just like:

-       Biopsy strategies in the era of mpMRI: a comprehensive review. Windisch O et al. Prostate Cancer Prostatic Dis. 2024 Sep 4. doi: 10.1038/s41391-024-00884-2. Online ahead of print. PMID: 39232094

-       Prostate cancer diagnostic pathway in men with lower urinary tract symptoms or performing opportunistic screening: The Italian Society of Urology (SIU) position paper. Ficarra V et al Minerva Urol Nephrol. 2024 Oct;76(5):530-535. doi: 10.23736/S2724-6051.24.06118-4. PMID: 39320245

-       Repeat prostate-specific antigen (PSA) test before prostate biopsy: a 20% decrease in PSA values is associated with a reduced risk of cancer and particularly of high-grade cancer. De Nunzio C et al.  BJU Int. 2018 Jul;122(1):83-88. doi: 10.1111/bju.14197. Epub 2018 Apr 10. PMID: 29533522

-       Organized prostate cancer screening program: a proposal from the Italian Society of Urology (SIU). Ficarra V et al.  Minerva Urol Nephrol. 2024 Oct;76(5):519-529. doi: 10.23736/S2724-6051.24.06117-2. PMID: 39320244

-       PSA screening for prostate cancer: the current controversy--a viewpoint. Patient Outcomes Research Team for Prostatic Diseases. Barry MJ. Ann Oncol. 1998. PMID: 9932155 Review.

-       Combining tissue biomarkers with mpMRI to diagnose clinically significant prostate cancer. Analysis of 21 biomarkers in the PICTURE study. Stopka-Farooqui U et al. Prostate Cancer Prostatic Dis. 2024 Nov 22. doi: 10.1038/s41391-024-00920-1. Online ahead of print. PMID: 39578642

Author Response

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Author Response File: Author Response.pdf