Impact of PSA testing on secondary care costs in England and Wales: estimates from the Cluster randomised triAl of PSA testing for Prostate cancer (CAP)

Journal article

Prostate cancer is the most common non-cutaneous cancer among men in the UK, causing significant health and economic burdens. Diagnosis and risk prognostication can be challenging due to the genetic and clinical heterogeneity of prostate cancer as well as uncertainties in our knowledge of the underlying biology and natural history of disease development. Urinary extracellular vesicles (EVs) are microscopic, lipid bilayer defined particles released by cells that carry a variety of molecular cargoes including nucleic acids, proteins and other molecules. Urine is a plentiful source of prostate-derived EVs. In this narrative review, we summarise the evidence on the function of urinary EVs and their applications in the evolving field of prostate cancer diagnostics and active surveillance. EVs are implicated in the development of all hallmarks of prostate cancer, and this knowledge has been applied to the development of multiple diagnostic tests, which are largely based on RNA and miRNA. Common gene probes included in multi-probe tests include PCA3 and ERG, and the miRNAs miR-21 and miR-141. The next decade will likely bring further improvements in the diagnostic accuracy of biomarkers as well as insights into molecular biological mechanisms of action that can be translated into opportunities in precision uro-oncology

Authors: Thorn, JC; Turner, EL; Walsh, EI; Donovan, JL; Neal, DE

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: BioMed Central
• Journal: BMC Health Services Research
• Volume: 23
• Issue: 1
• Pages: 610-610
• Article number: 610
• Publication date: 2023-06-09
• DOI: 10.1186/s12913-023-09503-7
• EISSN: 1472-6963
• ISSN: 1472-6963
• Language: English
• Keywords: Psychological intervention; Nursing; Test (biology); Public health; Health administration; Prostate-specific antigen; Population; Nursing research; Family medicine; Prostate cancer screening; Internal medicine; Confidence interval; Cluster randomised controlled trial; Health care; Prostate cancer; Medicine; Cancer; Environmental health; Randomized controlled trial