{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T16:05:24Z","timestamp":1779379524622,"version":"3.53.1"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["CA253910"],"award-info":[{"award-number":["CA253910"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Prostate cancer (PC) screening reduces PC mortality but also causes burden such as overdiagnosis and unnecessary biopsies. The European Association of Urology (EAU) recently proposed a risk\u2010adapted screening protocol incorporating prostate\u2010specific antigen (PSA)\u2010based intervals, a risk calculator (RC), and magnetic resonance imaging (MRI), though its long\u2010term outcomes remain unquantified. We constructed the MIcrosimulation SCreening Analysis\u2010PSA model by adapting the existing MIcrosimulation SCreening Analysis\u2010PROstate microsimulation framework to simulate individual PSA trajectories. The model parameters were calibrated to outcomes of the European Randomized Study of Screening for Prostate Cancer (ERSPC). Using this model, we simulated five screening protocols for men aged 55\u201369: fixed 4\u2010year intervals between PSA tests and a biopsy when PSA \u22653.0\u2009ng\/mL (ERSPC protocol); PSA\u2010based intervals; MRI prior to biopsy; the RC and MRI prior to biopsy; and the full EAU protocol (PSA\u2010based intervals, RC, and MRI). Outcomes included PC mortality, overdiagnoses, the number of PSA tests, biopsies, and MRIs. Compared to the ERSPC protocol, PSA\u2010based intervals reduced PSA tests by 21%. The MRI\u2010only protocol decreased overdiagnosis by 6% but also required many MRIs. Incorporating the RC further reduced overdiagnosis to 10% and required 36% fewer MRIs than the MRI\u2010only protocol. The EAU combines the best of all these approaches while maintaining equal PC mortality (200 deaths per 10,000 men). The EAU protocol optimizes long\u2010term screening efficiency, significantly reducing biopsies and overdiagnosis with minimal mortality trade\u2010offs. MRI and RC integration enhance resource allocation.<\/jats:p>","DOI":"10.1002\/ijc.70406","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T09:26:34Z","timestamp":1772961994000},"page":"432-439","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparing the effectiveness of prostate cancer screening protocols: European Association of Urology\u2013 and European Randomized Study of Screening for Prostate Cancer\u2013based strategies"],"prefix":"10.1002","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9823-2613","authenticated-orcid":false,"given":"Zhenwei","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Biostatistics Erasmus University Medical Center Rotterdam  Rotterdam The Netherlands"},{"name":"Department of Epidemiology Erasmus University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luuk A.","family":"van Duuren","sequence":"additional","affiliation":[{"name":"Department of Public Health Erasmus University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6967-1708","authenticated-orcid":false,"given":"Monique J.","family":"Roobol","sequence":"additional","affiliation":[{"name":"Department of Urology Erasmus University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole S.","family":"Erler","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Erasmus University Medical Center Rotterdam  Rotterdam The Netherlands"},{"name":"Department of Epidemiology Erasmus University Medical Center Rotterdam  Rotterdam The Netherlands"},{"name":"Julius Center for Health Sciences and Primary Care University Medical Center Utrecht, Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitris","family":"Rizopoulos","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Erasmus University Medical Center Rotterdam  Rotterdam The Netherlands"},{"name":"Department of Epidemiology Erasmus University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4890-6069","authenticated-orcid":false,"given":"Eveline A. 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