000132124 001__ 132124 000132124 005__ 20240711085510.0 000132124 0247_ $$2doi$$a10.1016/J.UROLONC.2023.09.020 000132124 0248_ $$2sideral$$a137277 000132124 037__ $$aART-2024-137277 000132124 041__ $$aeng 000132124 100__ $$aMorote, Juan 000132124 245__ $$aReducing the demand for magnetic resonance imaging scans and prostate biopsies during the early detection of clinically significant prostate cancer: Applying the Barcelona risk-stratified pathway in Catalonia 000132124 260__ $$c2024 000132124 5203_ $$aPurpose To analyze the reduction in multiparametric magnetic resonance imaging (mpMRI) demand and prostate biopsies after the hypothetical implementation of the Barcelona risk-stratified pathway (BCN-RSP) in a population of the clinically significant prostate cancer (csCaP) early detection program in Catalonia. Materials and Methods A retrospective comparation between the hypothetical application of the BCN-RSP and the current pathway, which relied on pre-biopsy mpMRI and targeted and/or systematic biopsies, was conducted. The BCN-RSP stratify men with suspected CaP based on a prostate specific antigen (PSA) level >10 ng/ml and a suspicious rectal examination (DRE), and the Barcelona-risk calculator 1 (BCN-RC1) to avoid mpMRI scans. Subsequently, candidates for prostate biopsy following mpMRI are selected based on the BCN-RC2. This comparison involved 3,557 men with serum PSA levels > 3.0 ng/ml and/or suspicious DRE. The population was recruited prospectively in 10 centers from January 2021 and December 2022. CsCaP was defined when grade group ≥ 2. Results CsCaP was detected in 1,249 men (35.1%) and insignificant CaP was overdeteced in 498 (14%). The BCN-RSP would have avoid 705 mpMRI scans (19.8%), and 697 prostate biopsies (19.6%), while 61 csCaP (4.9%) would have been undetected. The overdetection of insignificant CaP would have decrease in 130 cases (26.1%), and the performance of prostate biopsy for csCaP detection would have increase to 41.5%. Conclusion The application of the BCN-RSP would reduce the demand for mpMRI scans and prostate biopsies by one fifth while less than 5% of csCaP would remain undetected. The overdetection of insignificant CaP would decrease by more than one quarter and the performance of prostate biopsy for csCaP detection would increase to higher than 40%. 000132124 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/PI20/01666 000132124 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/ 000132124 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000132124 700__ $$0(orcid)0000-0003-0178-4567$$aBorque-Fernando, Ángel$$uUniversidad de Zaragoza 000132124 700__ $$0(orcid)0000-0002-3007-302X$$aEsteban, Luis E. 000132124 700__ $$aPicola, Natàlia 000132124 700__ $$aMuñoz-Rodríguez, Jesús 000132124 700__ $$aPaesano, Nahuel 000132124 700__ $$aRuiz-Plazas, Xavier 000132124 700__ $$aMuñoz-Rivero, Marta V. 000132124 700__ $$aCelma, Anna 000132124 700__ $$aGarcía-de Manuel, Gemma 000132124 700__ $$aMiró, Berta 000132124 700__ $$aAbascal, José M. 000132124 700__ $$aServian, Pol 000132124 7102_ $$11013$$2817$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Urología 000132124 773__ $$g42, 4 (2024), 115.e1-115.e7$$pUrol. Oncol.-Semin. Orig. Investig$$tUROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS$$x1078-1439 000132124 8564_ $$s613483$$uhttps://zaguan.unizar.es/record/132124/files/texto_completo.pdf$$yVersión publicada 000132124 8564_ $$s2309351$$uhttps://zaguan.unizar.es/record/132124/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000132124 909CO $$ooai:zaguan.unizar.es:132124$$particulos$$pdriver 000132124 951__ $$a2024-07-11-08:52:27 000132124 980__ $$aARTICLE