Four Dutch hospitals, including Radboudumc, are jointly launching a national pilot study on risk‑based prostate cancer screening. The participating centers are receiving a €3.2 million grant from KWF Dutch Cancer Society. The study, involving 25,000 men, aims to determine whether risk‑based prostate cancer screening is effective, feasible, and affordable for the Netherlands.
Prostate cancer is the most common cancer among men in the Netherlands. Each year, more than 15,000 men are diagnosed, and over 3,000 die from the disease. Prostate cancer is often detected late, because it usually causes no symptoms in its early stages. Early detection increases the chances of successful treatment. In colorectal cancer, population screening has already led to a clear reduction in metastatic disease. The aim of the new study is to investigate whether a risk‑based approach can deliver health benefits for prostate cancer.
Limitations of current detection
At present, men often visit their general practitioner on their own initiative for a PSA blood test to detect prostate cancer. The PSA test measures a substance produced by the prostate. An elevated PSA level may indicate prostate cancer but can also have benign causes. Since the introduction of prostate MRI, distinguishing between prostate cancer and benign conditions has improved, and targeted tissue sampling has become possible. This helps reduce unnecessary tests and treatments. However, the current approach to PSA testing is not systematic, and not all groups in society are reached equally well.
Study design
In the pilot study, 25,000 men aged fifty to seventy will be invited to undergo a PSA blood test. A key difference from the current practice is that an elevated result will be followed by a clear step‑by‑step plan for further testing. 'The volume of the prostate will then be measured using an abdominal ultrasound. If the ratio between PSA level and prostate volume is abnormal, an MRI of the prostate will be performed', says radiologist Maarten de Rooij, project leader at Radboud university medical center. 'Based on this MRI, physicians determine whether tissue samples from the prostate are needed for further examination and possible treatment.'
For participants, the study may provide greater clarity. A low PSA value can offer reassurance and prevent unnecessary follow‑up. If the value is elevated, further evaluation proceeds in a structured manner. An aggressive tumor may be detected earlier, increasing the chance of cure. A clear step‑by‑step plan helps reduce uncertainty and prevent unnecessary treatments.
The pilot has several focus areas. Researchers will examine whether they are reaching all groups within society and whether men are willing to participate. They will also assess the impact of the invitation, the test, and any follow‑up procedures on daily life. Finally, they will evaluate what nationwide implementation of prostate cancer screening would require from the healthcare system and whether it would be cost‑effective.
From research to implementation
The pilot study is led by urologist Roderick van den Bergh of Erasmus MC and is being conducted in collaboration with Radboudumc, Andros Clinics, the Netherlands Cancer Institute (Antoni van Leeuwenhoek), the Prostate Cancer Foundation, and Ghent University. The pilot aligns with European developments that recommend research into modern, risk‑based prostate cancer screening. The study results may form the basis for a decision on national implementation.
Before the study can begin, approval from the Health Council is required. Men cannot sign up for participation themselves; they will be invited through the study.
Project lead at Radboudumc radiologist Maarten de Rooij
-
Want to know more about these subjects? Click on the buttons below for more news.
