Cohort study of biomarkers of 20-year prostate cancer risk in men aged 45 to 70 years

Prostate cancer incidence is projected to double by 2040, yet optimal risk stratifications for screening remain unclear. A cohort study in Germany using data from the Study of Health in Pomerania (SHIP) identified biomarkers for risk-adapted prostate cancer screening in men without prostate cancer. In this cohort study of 2651 men aged 45 to 70 years with 20 years of follow-up, older age, higher PSA, and higher PSA density were associated with an increased hazard of developing prostate cancer. Men with baseline PSA less than 1.00 ng/ml had a 20-year prostate cancer risk of 3.3%. The authors conclude that these findings suggest that a low baseline PSA in midlife is associated with a substantially reduced risk of prostate cancer for up to 20 years, supporting risk-adapted screening strategies that reduced unnecessary procedures.