PROSTATE cancer screening compares favourably to breast cancer screening in identifying significant cancers, reducing mortality, and avoiding unnecessary harms, according to a meta-analysis presented today at the Annual Congress of the European Association of Urology 2026.
Prostate Cancer Screening
Prostate and breast cancer are among the most commonly diagnosed cancers in Europe among men and women, respectively. However, screening differs significantly.
Organised breast cancer screening programmes have been established across Europe for more than 3 decades, whilst prostate cancer screening has lagged. This is primarily due to concerns around the effectiveness of the prostate-specific antigen (PSA) blood test and the risks of overdiagnosis and overtreatment, researchers reported.
Nonetheless, many undergo variable, ‘opportunistic’ screening for prostate cancer, predominantly based on self-referral.
Associate professor Tobias Nordström, clinical urologist, Karolinska Institute, Sweden, said: “There is much that prostate cancer screening can learn form breast cancer screening and that is why this analysis is an important addition to our knowledge base.
“As these kinds of comparisons are very challenging, the results do need to be taken with a level of caution.
“That said, the clear overall similarities between the outcomes for breast and prostate screening show that we are moving in the right direction, ensuring prostate cancer screening offers more benefits than harm.”
Several prostate screening trials in Europe have now reported a reduced risk of death from prostate cancer, similar to that seen in breast screening programmes.
Favourable Results
Dr Sigrid Carlsson, leader of the Clinical Epidemiology of Early Cancer Detection, German Cancer Research Centre, Germany, caveated: “Until we have a population-based screening programme for prostate cancer, we can’t make an exact like-for-like comparison with breast cancer.
“But we can make some informed assumptions based on the data from our trial, which shows that if prostate cancer screening were extended to the wider population, then the outcomes are likely to be very similar to breast cancer.”
Researchers used data from nearly 40,000 men who underwent an initial PSA blood testing at age 45 or 50 as part of the PROBASE prostate cancer screening trial in Germany.
They also drew on data from more than 2.8 million women, aged 50-69-years-old, who had a mammography as part of the country’s breast screening programme.
PSA blood testing followed by an MRI scan leads to a higher number of false positives than mammography, researchers found. Analysis also revealed that a similar proportion of men and women were referred for biopsy.
Biopsies were much more likely to identify significant cancer in prostate screening than in breast screening, at 50-68% and 10%, respectively, leading researchers to suggest that fewer men were referred for biopsy unnecessarily. The percentages of invasive cancers identified were similar across both prostate and breast cancer screening services at 60-74% and 73%, respectively.
However, whilst prostate screening was able to identify 36-31% of non-aggressive cancers, breast screening trailed behind with a 22% identification rate. Researchers maintained that, in prostate cancer, the option of active surveillance is well-established, limiting the risk of overtreatment.
Implications for Urological Care
Carlsson continued: “Although our study used German data, the findings are applicable to other countries.
“The final question we now need to answer is: what will this cost compared to what we are already paying for opportunistic screening?
“And that work is already underway.”
Reference
Carlsson S et al. Risk-adapted prostate cancer screening achieves mammography-like benefits – results from the PROBASE trial. EAU26, 13-16 March, 2026.
Featured image: Alex Mit on Adobe Stock
