Targeted biopsy reduces detection of clinically insignificant cancer

Prostate-specific antigen (PSA) screening for prostate cancer typically involves serum PSA testing followed by a transrectal ultrasonography-guided systematic biopsy. Trials evaluating this approach have shown reductions in prostate cancer-associated mortality but have also raised concerns about overdiagnosis, overtreatment and biopsy-related adverse events (AEs). Now, data from the GÖTEBORG-2 trial demonstrate that MRI-guided targeted biopsy reduces the probability of detecting clinically insignificant cancers (Gleason 3 + 3) relative to systematic biopsy, although at the expense of missing some clinically significant cancers (Gleason ≥4 + 3).