Detection of Prostate Cancer in 2020 and Beyond

Dear All,

I am providing the main points as mentioned in the article by Van Poppel et al (2020) on ‘Early Detection of Prostate Cancer in 2020 and Beyond’ with suggestion of changes made by Laura Evangelista and Egesta Lopci* (2021). These flowcharts will help us as how we should evaluate patients suspected of P Ca taking into consideration towards minimizing of over diagnosis and thus unnecessary evaluations and treatment.

As we are now aware that P Ca can have different outcomes between Orientals and Caucasians, will the same proposed strategy will be useful in helping to detect csP Ca and thus avoid unnecessary Evaluations but at the same time not missing patients who need treatment and not Active Surveillance. The latter is not followed routinely in India but few centres are practicing it on highly educated clients.

I would appreciate our experts to spell out whether these proposals are suitable for our country.

With warm Regards,



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  • Dr. Roy Chally
    Dr. Roy Chally
    15 May 2021 02:43:49 PM

         They have come to this conclusion after trying many protocols in screening for cancer Prostate. The objective is to detect cancer Gleason score 7 and above. 

         In risk categorisation they have included a genetic testing. What is the marker? In screening this should be simple marker.
         PSA density is more valuable than other PSA permutations for screening. 
         Work needed to correlate Pirads score in mpMRI to cancer Prostate incidence 
    in India. 
        Socio economic demography of our population is very heterogeneous. I feel that our protocol will depend on Human Development Index, as this has a strong correlation with the incidence of CAProstate
         Till we generate some data, we will have to follow the western protocol for the affluent. 
         Here it may be worthwhile to note that standardisation of PSA test in the labs in our country, is a crying need of the time. 

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