The Effects of the Blood‐Based S2,3PSA% Test on Prostate Cancer Screening: A Novel Approach to Reduce the Need for MRI and Unnecessary Biopsies

作者：Hikari Miura, Tomoko Hamaya, Tohru Yoneyama, Tadashi Shimoyama, Fumiyasu Tsushima, Kyo Togashi, Yuki Miura, Anna Yoneyama, Hiroyuki Sato, Sosuke Omizo, Kazuyuki Mori, Hirotake Kodama, Naoki Fujita, Teppei Okamoto, Hayato Yamamoto, Shingo Kakeda, Chikara Οhyama, Shingo Hatakeyama · 发表于：The Prostate · 年份：2025 · DOI：10.1002/pros.24917 · 被引用次数：6 · 研究领域：Prostate Cancer Diagnosis and Treatment、Prostate Cancer Treatment and Research、Urologic and reproductive health conditions

OBJECTIVE: Prostate-specific antigen (PSA)-based screening has reduced prostate cancer (PCa) mortality but is associated with overdiagnosis/overtreatment. We developed and evaluated a blood-based S2,3PSA% test to address the limitations of PSA-based screening for PCa. METHODS: This retrospective study included men aged ≤ 75 years who underwent opportunistic PSA and S2,3PSA% screening between April 2022 and March 2023. Secondary screening was recommended for participants with PSA ≥ 2.0 ng/mL and S2,3PSA% ≥ 38.0%, or PSA ≥ 4.0 ng/mL. The primary outcome was the reduction in MRI utilization based on an S2,3PSA% cutoff of ≥ 38.0%. Secondary outcomes included the PCa detection rate, as well as reductions in prostate biopsies and medical costs. RESULTS: Among 808 participants who underwent PSA and S2,3PSA% screening, 190 met the criteria for secondary screening. Of these, 72 underwent further evaluation, including MRI in 65 participants. MRI findings excluded 22 (33.8%) participants from requiring prostate biopsy. Ultimately, 25 participants underwent prostate biopsy, and PCa was diagnosed in 17 (68.0%), including 12 with clinically significant PCa. The combined use of PSA, S2,3PSA%, and MRI resulted in a 44% reduction in MRI use, a 63% reduction in unnecessary biopsies, and a 72% reduction in medical costs. Study limitations include the small sample size and lack of evaluation of participants with negative S2,3PSA% or MRI findings. CONCLUSIONS: S2,3PSA% screening may have potentia...