{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:22:42Z","timestamp":1792034562651,"version":"4.4.0"},"reference-count":148,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Prostate cancer (PCa) is one of the most common malignancies among men worldwide. While prostate-specific antigen (PSA) screening has improved early detection, it has also led to significant challenges regarding overdiagnosis and overtreatment. Overdiagnosis involves identifying indolent tumors unlikely to affect a patient\u2019s lifespan, while overtreatment refers to unnecessary interventions that can cause adverse effects such as urinary incontinence, erectile dysfunction, and a reduced quality of life. This review highlights contributing factors, including the limitations of PSA testing, advanced imaging techniques like multi-parametric MRI (mpMRI), medical culture, and patient expectations. The analysis emphasizes the need for refining screening protocols, integrating novel biomarkers (e.g., PCA3, TMPRSS2-ERG), and adopting conservative management strategies such as active surveillance to minimize harm. Risk-based screening and shared decision-making are critical to balancing the benefits of early detection with the risks of unnecessary treatment. Additionally, systemic healthcare factors like financial incentives and malpractice concerns exacerbate overuse. This review advocates for updated clinical guidelines and personalized approaches to optimizing patient outcomes while reducing the strain on healthcare resources. Addressing overdiagnosis and overtreatment through targeted interventions will improve the quality of life for PCa patients and enhance the efficiency of healthcare systems.<\/jats:p>","DOI":"10.3390\/diseases13060167","type":"journal-article","created":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T20:16:22Z","timestamp":1748204182000},"page":"167","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Overdiagnosis and Overtreatment in Prostate Cancer"],"prefix":"10.3390","volume":"13","author":[{"given":"Zaure","family":"Dushimova","sequence":"first","affiliation":[{"name":"Department of Fundamental Medicine, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yerbolat","family":"Iztleuov","sequence":"additional","affiliation":[{"name":"NJSC \u201cMarat Ospanov West Kazakhstan Medical University\u201d, Aktobe 030019, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6267-5351","authenticated-orcid":false,"given":"Gulnar","family":"Chingayeva","sequence":"additional","affiliation":[{"name":"S.D. Asfendiyarov Kazakh National Medical University, Tole Bi Street 94, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2201-5946","authenticated-orcid":false,"given":"Abay","family":"Shepetov","sequence":"additional","affiliation":[{"name":"S.D. Asfendiyarov Kazakh National Medical University, Tole Bi Street 94, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagima","family":"Mustapayeva","sequence":"additional","affiliation":[{"name":"S.D. Asfendiyarov Kazakh National Medical University, Tole Bi Street 94, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oxana","family":"Shatkovskaya","sequence":"additional","affiliation":[{"name":"National Research Oncology Center, Astana 020000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marat","family":"Pashimov","sequence":"additional","affiliation":[{"name":"JSC \u201cResearch Institute of Cardiology and Internal Diseases\u201d, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5696-6363","authenticated-orcid":false,"given":"Timur","family":"Saliev","sequence":"additional","affiliation":[{"name":"S.D. Asfendiyarov Kazakh National Medical University, Tole Bi Street 94, Almaty 050000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Cui, H.J., Zhang, W., Zhang, L., Qu, Y., Xu, Z., Tan, Z., Yan, P., Tang, M., Yang, C., and Wang, Y. (2024). Risk factors for prostate cancer: An umbrella review of prospective observational studies and mendelian randomization analyses. PLoS Med., 21.","DOI":"10.1371\/journal.pmed.1004362"},{"key":"ref_2","first-page":"101876","article-title":"Prostate cancer screening with prostate-specific antigen (PSA) to men over 70 years old in an urban health zone, 2018\u20132020: A cross-sectional study","volume":"49","year":"2023","journal-title":"Med. 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