Thirty years have passed since clinicians started using prostate-specific antigen level as a screening tool for prostate cancer. Over the years, the diagnosis of metastatic disease has decreased dramatically, and there has been a considerable decline in mortality.1,2 However, clinicians have struggled to find the balance between early diagnoses of lethal prostate cancer and overdiagnoses of clinically insignificant disease. Some lessons have been learned from large clinical trials, leading to the adjustment of the age and rate of screening and the development of better tests. In addition, better understanding of risk stratification and the role of active surveillance have improved treatment algorithms. In the recent past, technological advances have facilitated diagnosis. Specifically, multiparametric magnetic resonance imaging (MRI) of the prostate has significantly improved the detection of clinically significant cancer.
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Shabsigh A, Lee CT. Closing the Loop on the Role of Multiparametric Magnetic Resonance Imaging–Targeted Prostate Biopsy. JAMA Surg. Published online June 12, 2019. doi:10.1001/jamasurg.2019.1735
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