Urol. praxi. 2025;26(4):196-200 | DOI: 10.36290/uro.2025.086

Current prostate cancer diagnostics

MUDr. Jiří Stejskal, Ph.D., FEBU
Urologická klinika 1. LF UK a ÚVN, Praha

This review article presents current recommendations for prostate cancer detection, while considering local specifics. It discus­ses the topics of initiating diagnostics, prostate cancer screening, the use of imaging methods, and indications and techniques of prostate biopsy. The article is based on the latest guidelines of the European Association of Urology.

Keywords: prostate cancer, diagnostics, screening.

Accepted: November 24, 2025; Published: December 16, 2025  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Stejskal J. Current prostate cancer diagnostics. Urol. praxi. 2025;26(4):196-200. doi: 10.36290/uro.2025.086.
Download citation

References

  1. Cornford P, Tilki D, van den Bergh RCN, et al. EAU Guidelines on Prostate Cancer [Internet]. 2025 [cited 2025 Mar 27]. EAU Guidelines. Edn. presented at the EAU Annual Congress Madrid 2025. Available from: https://uroweb.org/guidelines/prostate-cancer.
  2. Stejskal J, Adamcová V, Záleský M, et al. The predictive value of the prostate health index vs. multiparametric magnetic resonance imaging for prostate cancer diagnosis in prostate biopsy. World J Urol. 2021;39(6):1889-1895. Go to original source...
  3. Novák V, Veselý Š, Lukšanová H, et al. Preoperative prostate health index predicts adverse pathology and Gleason score upgrading after radical prostatectomy for prostate cancer. BMC Urol [Internet]. 2020;20 [cited 2020 Oct 12]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487536/. Go to original source...
  4. Fiala V, Sobotka R, Vaľová Z, et al. Zkušenosti s použitím indexu zdraví prostaty v klinické praxi. Čes Urol. 2017;21(4):284-288. Go to original source...
  5. Řezáč J, Čapoun O, Soukup V. Sérové onkomarkery karcinomu prostaty. Čes Urol. 2021;25(4):236-243. Go to original source...
  6. Stejskal J, Jašková V, Pavličko A, et al. Diagnostika karcinomu prostaty pomocí fúzní biopsie. Čes Urol. 2018;22(2):87-98. Go to original source...
  7. Studenski S, Perera S, Patel K, et al. Gait speed and survival in older adults. JAMA. 2011;305(1):50-58. Go to original source... Go to PubMed...
  8. Soubeyran P, Bellera C, Goyard J, et al. Screening for vulnerability in older cancer patients: the ONCODAGE Prospective Multicenter Cohort Study. PloS One. 2014;9(12):e115060. Go to original source... Go to PubMed...
  9. Mini-Cog© - Quick Screening for Early Dementia Detection [Internet]. [cited 2025 Jul 25]. Available from: https://mini-cog.com/.
  10. Hayes JH, Barry MJ. Screening for prostate cancer with the prostate-specific antigen test: a review of current evidence. J Am Med Assoc. 2014;311(11):1143-1149. Go to original source...
  11. Ilic D, O'Connor D, Green S, et al. Screening for prostate cancer: a Cochrane systematic review. Cancer Causes Control. 2007;18(3):279-285. Go to original source...
  12. Schröder FH, Hugosson J, Roobol MJ, et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. The Lancet. 2014;384(9959):2027-2035. Go to original source... Go to PubMed...
  13. Hugosson J, Roobol MJ, Månsson M, et al. A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer. Eur Urol. 2019;76(1):43-51. Go to original source... Go to PubMed...
  14. Hugosson J, Godtman R, Carlsson S, et al. Eighteen-year follow-up of the Göteborg Randomized Population-based Prostate Cancer Screening Trial: effect of sociodemographic variables on participation, prostate cancer incidence and mortality. Scand J Urol [Internet]. 2018;52(1) [cited 2025 Jul 27]. Available from: https://pubmed.ncbi.nlm.nih.gov/29254399/. Go to original source... Go to PubMed...
  15. Marmot M, Altman D, Cameron D, et al. The benefits and harms of breast cancer screening: an independent review. The Lancet. 2012;380(9855):1778-1786. Go to original source... Go to PubMed...
  16. Zachoval R, Dušek L, Babjuk M. Problematika screeningu karcinomu prostaty. Čes Urol. 2018;22(1):14-26. Go to original source...
  17. Stejskal J, Zachoval R. Screening karcinomu prostaty - vývoj, aktuální doporučení a výhled do budoucna. Practicus. 2022;21(3):24-28.
  18. Česká urologická společnost [Internet]. [cited 2025 Mar 27]. Program časného záchytu karcinomu prostaty v ČR. Available from: https://www.cus.cz/o-spolecnosti/program-casneho-zachytu-karcinomu-prostaty-v-cr/.
  19. Carvalhal GF, Smith DS, Mager DE, et al. Digital rectal examination for detecting prostate cancer at prostate specific antigen levels of 4 ng./ml. or less. J Urol. 1999;161(3):835-839. Go to original source...
  20. Thompson IM, Pauler DK, Goodman PJ, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. N Engl J Med. 2004;350(22):2239-2246. Go to original source...
  21. Shariat SF, Roehrborn CG. Using Biopsy to Detect Prostate Cancer. Rev Urol. 2008;10(4):262-280.
  22. Záleský M, Stejskal J, Adamcová V, et al. Use of Prostate Specific Antigen Density Combined with Multiparametric Magnetic Resonance Imaging Improves Triage for Prostate Biopsy. Urol Int. 2019;103(1):33-40. Go to original source... Go to PubMed...
  23. Stejskal J, Adamcová V, Pavličko A, et al. Porovnání měření velikosti prostaty pomocí transrektálního ultrazvuku a magnetické rezonance a jejich vlivu na PSA denzitu. Čes Urol. 2019;23(4):325-332.
  24. van de Ven WJM, Sedelaar JPM, van der Leest MMG, et al. Visibility of prostate cancer on transrectal ultrasound during fusion with multiparametric magnetic resonance imaging for biopsy. Clin Imaging. 2016;40(4):745-750. Go to original source... Go to PubMed...
  25. Smeenge M, Barentsz J, Cosgrove D, et al. Role of transrectal ultrasonography (TRUS) in focal therapy of prostate cancer: report from a Consensus Panel. BJU Int. 2012;110(7):942-948. Go to original source... Go to PubMed...
  26. Kinnaird A, Luger F, Cash H, et al. Microultrasonography-Guided vs MRI-Guided Biopsy for Prostate Cancer Diagnosis: The OPTIMUM Randomized Clinical Trial. JAMA. 2025;333(19):1679-1687. Go to original source...
  27. Twilt JJ, Saha A, Bosma JS, et al. Evaluating Biparametric Versus Multiparametric Magnetic Resonance Imaging for Diagnosing Clinically Significant Prostate Cancer: An International, Paired, Noninferiority, Confirmatory Observer Study. Eur Urol. 2025;87(2):240-250. Go to original source... Go to PubMed...
  28. Rouvière O, Jaouen T, Baseilhac P, et al. Artificial intelligence algorithms aimed at characterizing or detecting prostate cancer on MRI: How accurate are they when tested on independent cohorts? - A systematic review. Diagn Interv Imaging [Internet]. 2023;104(5) [cited 2025 Jul 27]. Available from: https://pubmed.ncbi.nlm.nih.gov/36517398/. Go to original source...
  29. Bruyère F, d'Arcier BF, Boutin JM, et al. Is urine culture routinely necessary before prostate biopsy? Prostate Cancer Prostatic Dis. 2010;13(3):260-262. Go to original source... Go to PubMed...
  30. Castellani D, Pirola GM, Law YXT, et al. Infection Rate after Transperineal Prostate Biopsy with and without Prophylactic Antibiotics: Results from a Systematic Review and Meta-Analysis of Comparative Studies. J Urol. 2022;207(1):25-34. Go to original source... Go to PubMed...
  31. Basourakos SP, Alshak MN, Lewicki PJ, et al. Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis. Eur Urol Open Sci. 2022;37:53-63. Go to original source...
  32. Jacewicz M, Günzel K, Rud E, et al. Antibiotic prophylaxis versus no antibiotic prophylaxis in transperineal prostate bio­psies (NORAPP): a randomised, open-label, non-inferiority trial. Lancet Infect Dis. 2022;22(10):1465-1471. Go to original source... Go to PubMed...
  33. Brisbane W, Priester A, Ballon J, et al. Targeted Prostate Bio­psy: Umbra, Penumbra, and Value of Perilesional Sampling. Eur Urol [Internet]. 2022;82(3) [cited 2025 Jul 27]. Available from: https://pubmed.ncbi.nlm.nih.gov/35115177/. Go to original source...




Urology for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.