Overcoming Pitfalls in the Detection and Definition of Clinically Significant Prostate Cancer: Strategies to Improve Screening and Diagnosis
A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".
Deadline for manuscript submissions: 30 June 2025 | Viewed by 1124
Special Issue Editor
2. Department of Medicine (DIMED), University of Padua, 35128 Padova, Italy
Interests: urology
Special Issues, Collections and Topics in MDPI journals
Special Issue Information
Dear Colleagues,
Prostate cancer is one of the most common cancers worldwide, with 1 in 8 men expected to receive a diagnosis during their lifetime. While many of these cases are indolent and do not significantly affect life expectancy, others can progress to aggressive forms with metastatic spreading, significantly impacting both quality of life and survival. Early diagnosis is critical, particularly for younger patients with a family history of prostate or breast cancer.
The definitive diagnosis of prostate cancer is typically established through prostate biopsy. However, before a biopsy is performed, several tests are commonly used, though each has limitations in terms of sensitivity and specificity. Digital rectal examination and prostate-specific antigen (PSA) testing are commonly employed, but their positive predictive values are low, being 18% and 25% respectively.
PSA testing can be refined using different approaches, such as monitoring PSA velocity, the free-to-total PSA ratio, the PSA density, or the Prostate Health Index (PHI). While these methods can enhance sensitivity, their accuracy remains limited.
Prostate magnetic resonance imaging (MRI) plays a pivotal role in the diagnostic pathway, offering high sensitivity in detecting tumors. However, MRI scans can still miss aggressive cancers, particularly smaller lesions.
Finally, despite advances in imaging and biomarkers, prostate biopsy remains the gold standard for diagnosis. However, false-negative results can occur, and additional diagnostic tools, such as the urine PCA3 test or serum kallikrein-related peptidase 2 combined with PSA, may be necessary for patient selection, especially when considering repeat biopsy in cases of persistent concern.
While the diagnostic approach to prostate cancer continues to evolve, ongoing challenges remain in terms of the sensitivity and specificity of the available exams.
This Special Issue will publish original research articles and comprehensive reviews that address the challenges associated with prostate cancer screening, as well as the diagnosis and definition of clinically significant tumors based on the use of advanced imaging and biomarkers. We are particularly interested in studies exploring the use of novel serum-, urine-, and tissue-based biomarkers before or after prostate biopsy, especially in patients with negative MRI findings. Research for identifying or validating new molecular tests for prostate cancer diagnosis is of high interest. Additionally, studies investigating the innovative use of well-established biomarkers and/or imaging for prostate cancer diagnosis and the identification of aggressive tumors are also welcomed.
We look forward to receiving your contributions.
Dr. Fabio Zattoni
Guest Editor
Manuscript Submission Information
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Keywords
- prostate cancer
- PSA
- magnetic resonance of the prostate
- prostatic tissue-based biomarkers
- prostate biopsy
- prostate cancer screening
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