{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T23:15:22Z","timestamp":1788218122803,"version":"build-2803163510"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die Fr\u00fcherkennung des Prostatakarzinoms in Deutschland ist weiterhin \u00fcberwiegend opportunistisch. Ein organisiertes, qualit\u00e4tsgesichertes und einladungsbasiertes Programm existiert nicht; stattdessen wird die Versorgung durch heterogene Testung des prostataspezifischen Antigens (PSA), variable Beratung und inkonsistente diagnostische Folgepfade gepr\u00e4gt. Zugleich haben sich Evidenzlage und Leitlinienstand deutlich weiterentwickelt. Die aktualisierte deutsche S3-Leitlinie empfiehlt nach ergebnisoffener Beratung ab dem 45. Lebensjahr eine PSA-basierte, risikoadaptierte Fr\u00fcherkennungsstrategie mit Basis-PSA, intervallgesteuerter Wiedervorstellung und definierter weiterer Abkl\u00e4rung. Die EAU-Leitlinie 2026 folgt demselben Grundprinzip einer individualisierten, risikoadaptierten Fr\u00fcherkennung, w\u00e4hlt f\u00fcr M\u00e4nner ohne zus\u00e4tzliche Risikofaktoren jedoch mit 50 Jahren einen zur\u00fcckhaltenderen Einstieg. Die entscheidende Frage lautet daher nicht mehr, ob eine unselektierte j\u00e4hrliche PSA-Testung f\u00fcr alle M\u00e4nner sinnvoll ist, sondern ob Deutschland den \u00dcbergang von opportunistischer Testung zu einer strukturierten, individualisierten und qualit\u00e4tsgesicherten Fr\u00fcherkennung jetzt konsequent vollziehen sollte. Vieles spricht daf\u00fcr, diesen Weg bereits ab dem 45. Lebensjahr mit einer ersten strukturierten Beratung und einem Basis-PSA zu er\u00f6ffnen, nicht als Einladung zur \u00dcbertestung, sondern als Einstieg in ein risikoorientiertes Konzept mit verl\u00e4ngerbaren Kontrollintervallen bei niedrigem Risiko. Ein solcher Ansatz ist klinisch plausibel, epidemiologisch begr\u00fcndbar, durch aktuelle deutsche und europ\u00e4ische Daten zunehmend gest\u00fctzt und gesundheitspolitisch \u00fcberzeugender als die Fortsetzung der bisherigen Grauzone zwischen gesetzlicher Fr\u00fcherkennung mittels digital-rektaler Untersuchung und faktisch opportunistischer PSA-Testung.<\/jats:p>","DOI":"10.1055\/a-2897-1642","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T23:15:16Z","timestamp":1783552516000},"page":"479-486","source":"Crossref","is-referenced-by-count":0,"title":["Von der opportunistischen PSA-Testung zur individualisierten, risikobasierten Fr\u00fcherkennung des Prostatakarzinoms in Deutschland"],"prefix":"10.1055","volume":"57","author":[{"given":"Christian","family":"Gilfrich","sequence":"first","affiliation":[{"name":"St. Elisabeth-Klinikum Straubing, Medizin-Campus Niederbayern (MCN), Deutschland","place":["Straubing"],"department":["Klinik f\u00fcr Urologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Lebentrau","sequence":"first","affiliation":[{"name":"Universit\u00e4tsklinikum Magdeburg, Deutschland","place":["Magdeburg"],"department":["Klinik f\u00fcr Urologie, Uroonkologie, robotergest\u00fctzte und fokale Therapie"]},{"name":"GLG Werner Forssmann Klinikum Eberswalde, Deutschland","place":["Eberswalde"],"department":["Urologische Klinik"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"May","sequence":"additional","affiliation":[{"name":"St. Elisabeth-Klinikum Straubing, Medizin-Campus Niederbayern (MCN), Deutschland","place":["Straubing"],"department":["Klinik f\u00fcr Urologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Burger","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Regensburg, Caritas-Krankenhaus St. Josef, Bayern, Deutschland","place":["Regensburg"],"department":["Klinik f\u00fcr Urologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingmar","family":"Wolff","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsmedizin Greifswald, Deutschland","place":["Greifswald"],"department":["Klinik und Poliklinik f\u00fcr Urologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay-Patrick","family":"Braun","sequence":"additional","affiliation":[{"name":"Otto-von-Guericke-Universit\u00e4t Magdeburg, Deutschland","place":["Magdeburg"],"department":["Institut f\u00fcr Allgemeinmedizin"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Haas","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Regensburg, Caritas-Krankenhaus St. Josef, Bayern, Deutschland","place":["Regensburg"],"department":["Klinik f\u00fcr Urologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Siepmann","sequence":"additional","affiliation":[{"name":"St. Elisabeth-Klinikum Straubing, Medizin-Campus Niederbayern (MCN), Deutschland","place":["Straubing"],"department":["Klinik f\u00fcr Urologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e071082","DOI":"10.1136\/bmj-2022-071082","article-title":"Current policies on early detection of prostate cancer create overdiagnosis and inequity with minimal benefit","volume":"381","author":"A Vickers","year":"2023","journal-title":"BMJ"},{"key":"ref3","volume-title":"EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer. 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