Prostate Cancer Screening and Current Treatment: A Brief Updated Review

Abstract

Prostate cancer is the second most incident malignant tumor among men worldwide and the leading urological neoplasm in developed countries. In Brazil, estimates from the National Cancer Institute point to approximately 65,840 new cases in 2020, corresponding to 29.2% of all male neoplasms. Systematic screening primarily based on prostate specific antigen (PSA) testing and digital rectal examination aims to reduce mortality through early diagnosis. However, survival benefits are counterbalanced by risks of overdiagnosis, unnecessary biopsies, and complications from invasive treatments. Advances in imaging techniques, such as multiparametric magnetic resonance imaging (mpMRI), have improved candidate selection for biopsy, reducing superfluous procedures. In the therapeutic landscape, developments include robotic radical prostatectomy, advanced conformal radiotherapy, androgen deprivation therapy, and next generation agents (abiraterone and enzalutamide), alongside the consolidation of active surveillance for low risk tumors. This review integrates recent evidence on prostate cancer screening and management, analyzing benefits, limitations, and current gaps. It concludes that despite technological and therapeutic progress, the challenge of personalizing decisions to maximize benefit and minimize harm remains, highlighting the need for research validating individualized risk tools and new treatment modalities.