Prostate cancer is common and occurs in 1 out of 9 men in their lifetime. Even though most prostate cancer cases carry a good prognosis for life, it remains the second highest cause of cancer death in men, and even cases initially detected as low-risk can often evolve to require treatment.
Prostate Specific Antigen (PSA) tests are used in population-based screening programmes and are shown to reduce the mortality rate. However, the debate on overdiagnosis and overtreatment continues, as the harms of false positives and overtreatment of benign disease outweigh the benefits. New approaches to screening programmes are currently being discussed. Screening men at a higher risk would attain a much greater risk-to-benefit balance from the PSA test.
Active personalised monitoring based on genetic and conventional risk factors balances competing health risks and may prove useful in the design of screening and treatment schemes. Our aim is to develop and implement new risk-adapted screening programmes that reduce overdiagnosis and to detect men with early stages of prostate cancer based on advanced risk models that account for both genetic and environmental risk factors.