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      Targeted Prostate Health Checks, a novel system to identify men with prostate cancer—A pilot study

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          Abstract

          Objectives

          The objective of this study is to report the pilot phase of the Targeted Prostate Health Check programme that aims to identify men in the Surrey and Sussex region who have prostate cancer and who failed to be detected during the Covid era.

          Subjects and methods

          Men aged 50 to 70, or 45 to 70 if Black or with a family history of prostate cancer, were identified from participating general practitioner (GP) records. Short message service (SMS) texts invited men to visit www.talkprostate.co.uk for information on prostate cancer and give consent to prostate‐specific antigen (PSA) checks coordinated by a third‐party virtual healthcare provider. Elevated age‐related PSA levels, or levels below age‐related thresholds but at 3 ng/mL or more, triggered referral to a rapid access urology clinic. GPs were informed of the results.

          Results

          From 1842 text messages inviting 1549 people, 544 men consented to a PSA check. From 500 phlebotomy appointments, 485 (30% of invited men) took the PSA test of whom 68 (14%) were referred with an elevated PSA. After clinical review with multiparametric magnetic resonance imaging (mp‐MRI), 22 patients underwent transperineal biopsies, and prostate cancer was detected in 18 men of whom 17 (95%) had clinically significant cancer.

          Conclusion

          Our Targeted Prostate Cancer Health Check system identifies men at risk without burdening primary care. Awareness on prostate cancer risk was raised in 1549 invited men, half of whom were further educated via the registration website. One third of invited men were checked in whom clinically significant prostate cancer was found in 3.5%.

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          Most cited references13

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          Is Open Access

          Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study

          Men with high serum prostate specific antigen usually undergo transrectal ultrasound-guided prostate biopsy (TRUS-biopsy). TRUS-biopsy can cause side-effects including bleeding, pain, and infection. Multi-parametric magnetic resonance imaging (MP-MRI) used as a triage test might allow men to avoid unnecessary TRUS-biopsy and improve diagnostic accuracy.
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            MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis

            Multiparametric magnetic resonance imaging (MRI), with or without targeted biopsy, is an alternative to standard transrectal ultrasonography-guided biopsy for prostate-cancer detection in men with a raised prostate-specific antigen level who have not undergone biopsy. However, comparative evidence is limited.
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              • Record: found
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              • Article: not found

              The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part B: Prostate and Bladder Tumours.

              It has been 12 yr since the publication of the last World Health Organization (WHO) classification of tumours of the prostate and bladder. During this time, significant new knowledge has been generated about the pathology and genetics of these tumours. Intraductal carcinoma of the prostate is a newly recognized entity in the 2016 WHO classification. In most cases, it represents intraductal spread of aggressive prostatic carcinoma and should be separated from high-grade prostatic intraepithelial neoplasia. New acinar adenocarcinoma variants are microcystic adenocarcinoma and pleomorphic giant cell adenocarcinoma. Modifications to the Gleason grading system are incorporated into the 2016 WHO section on grading of prostate cancer, and it is recommended that the percentage of pattern 4 should be reported for Gleason score 7. The new WHO classification further recommends the recently developed prostate cancer grade grouping with five grade groups. For bladder cancer, the 2016 WHO classification continues to recommend the 1997 International Society of Urological Pathology grading classification. Newly described or better defined noninvasive urothelial lesions include urothelial dysplasia and urothelial proliferation of uncertain malignant potential, which is frequently identified in patients with a prior history of urothelial carcinoma. Invasive urothelial carcinoma with divergent differentiation refers to tumours with some percentage of "usual type" urothelial carcinoma combined with other morphologies. Pathologists should mention the percentage of divergent histologies in the pathology report.
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                Author and article information

                Contributors
                stephenlangley@nhs.net
                Journal
                BJUI Compass
                BJUI Compass
                10.1002/(ISSN)2688-4526
                BCO2
                BJUI Compass
                John Wiley and Sons Inc. (Hoboken )
                2688-4526
                15 August 2024
                October 2024
                : 5
                : 10 ( doiID: 10.1002/bco2.v5.10 )
                : 969-975
                Affiliations
                [ 1 ] The Stokes Centre for Urology Royal Surrey Hospital NHS Foundation Trust Guildford UK
                [ 2 ] Medefer Ltd London UK
                [ 3 ] Surrey and Sussex Cancer Alliance Guildford UK
                [ 4 ] Surrey Primary Care Lead Surrey & Sussex Cancer Alliance Guildford UK
                [ 5 ] Wexham Park Hospital Slough Berkshire UK
                [ 6 ] Frimley Park Hospital, Frimley Health NHS Foundation Trust Frimley UK
                Author notes
                [*] [* ] Correspondence

                Stephen Langley, The Stokes Centre for Urology, Royal Surrey Hospital NHS Foundation Trust, Egerton Road, Guildford GU2 7XX, UK.

                Email: stephenlangley@ 123456nhs.net

                Author information
                https://orcid.org/0000-0003-1785-2421
                https://orcid.org/0000-0003-1761-0115
                Article
                BCO2416
                10.1002/bco2.416
                11479803
                39416751
                6593fc0e-9387-4463-803c-fdc0b67e3e42
                © 2024 The Author(s). BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 June 2024
                : 27 March 2024
                : 13 July 2024
                Page count
                Figures: 2, Tables: 1, Pages: 7, Words: 4900
                Funding
                Funded by: NHS England , doi 10.13039/100012360;
                Categories
                Original Article
                Original Article
                Custom metadata
                2.0
                October 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.9 mode:remove_FC converted:15.10.2024

                health check,multiparametric‐mri,prostate cancer,prostate‐specific antigen,psa,transperineal biopsy

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