000131276 001__ 131276
000131276 005__ 20240207154753.0
000131276 0247_ $$2doi$$a10.3390/jpm14020130
000131276 0248_ $$2sideral$$a136771
000131276 037__ $$aART-2024-136771
000131276 041__ $$aeng
000131276 100__ $$aMorote, Juan
000131276 245__ $$aInvestigating efficient risk-stratified pathways for the early detection of clinically significant prostate cancer
000131276 260__ $$c2024
000131276 5060_ $$aAccess copy available to the general public$$fUnrestricted
000131276 5203_ $$aRisk-stratified pathways (RSPs) are recommended by the European Association of Uro-logy (EAU) to improve the early detection of clinically significant prostate cancer (csPCa). RSPs can reduce magnetic resonance imaging (MRI) demand, prostate biopsies, and the over-detection of insignificant PCa (iPCa). Our goal is to analyze the efficacy and cost-effectiveness of several RSPs by using sequential stratifications from the serum prostate-specific antigen level and digital rectal examination, the Barcelona risk calculators (BCN-RCs), MRI, and Proclarix™. In a cohort of 567 men with a serum PSA level above 3.0 ng/mL who underwent multiparametric MRI (mpMRI) and targeted and/or systematic biopsies, the risk of csPCa was retrospectively assessed using Proclarix™ and BCN-RCs 1 and 2. Six RSPs were compared with those recommended by the EAU that, stratifying men from MRI, avoided 16.7% of prostate biopsies with a prostate imaging–reporting and data system score of <3, with 2.6% of csPCa cases remaining undetected. The most effective RSP avoided mpMRI exams in men with a serum PSA level of >10 ng/mL and suspicious DRE, following stratifications from BCN-RC 1, mpMRI, and Proclarix™. The demand for mpMRI decreased by 19.9%, prostate biopsies by 19.8%, and over-detection of iPCa by 22.7%, while 2.6% of csPCa remained undetected as in the recommended RSP. Cost-effectiveness remained when the Proclarix™ price was assumed to be below EUR 200.
000131276 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/PI20/01666
000131276 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000131276 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000131276 700__ $$0(orcid)0000-0003-0178-4567$$aBorque-Fernando, Ángel$$uUniversidad de Zaragoza
000131276 700__ $$0(orcid)0000-0002-3007-302X$$aEsteban, Luis M.
000131276 700__ $$aCelma, Ana
000131276 700__ $$aCampistol, Miriam
000131276 700__ $$aMiró, Berta
000131276 700__ $$aMéndez, Olga
000131276 700__ $$aTrilla, Enrique
000131276 7102_ $$11013$$2817$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Urología
000131276 773__ $$g14, 2 (2024), 130 [15 pp.]$$pJ. pers. med.$$tJournal of Personalized Medicine$$x2075-4426
000131276 8564_ $$s3129087$$uhttps://zaguan.unizar.es/record/131276/files/texto_completo.pdf$$yVersión publicada
000131276 8564_ $$s2758143$$uhttps://zaguan.unizar.es/record/131276/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000131276 909CO $$ooai:zaguan.unizar.es:131276$$particulos$$pdriver
000131276 951__ $$a2024-02-07-14:36:42
000131276 980__ $$aARTICLE