Prostate cancer screening of specific adult population groups. Guidelines

These guidelines contain information on the theoretical foundations of prostate cancer screening, regulatory acts governing the management of prostate cancer screening of specific adult population groups, the specifics of interpreting the results of laboratory and imaging examinations during prostate cancer screening, and patient routing algorithms.

These guidelines have been developed for the heads of health facilities providing primary healthcare, including primary care physicians, general practitioners, urologists, and specialists with secondary medical education who are directly involved in outpatient screening of specific adult population groups.

1. Cornford P, van den Bergh RCN, Briers E, et al.. EAU-EANM-ESTRO-ESUR-ISUPSIOG Guidelines on Prostate Cancer-2024 Update. Part I: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2024;86(2):148-63. doi:10.1016/j.eururo.2024.03.027.

2. Culp MB, Soerjomataram I, Efstathiou JA, et al. Recent Global Patterns in Prostate Cancer Incidence and Mortality Rates. Eur Urol. 2020;77(1):38-52. doi:10.1016/j.eururo.2019.08.005.

3. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-63. doi:10.3322/caac.21834.

4. Haas GP, Delongchamps N, Brawley OW, et al. The worldwide epidemiology of prostate cancer: perspectives from autopsy studies. Can J Urol. 2008;15(1):3866-71.

5. Bell KJ, Del Mar C, Wright G, et al. Prevalence of incidental prostate cancer: A systematic review of autopsy studies. Int J Cancer. 2015;137(7):1749-57. doi:10.1002/ijc.29538.

6. Fleshner K, Carlsson SV, Roobol MJ. The effect of the USPSTF PSA screening recommendation on prostate cancer incidence patterns in the USA. Nat Rev Urol. 2017;14(1):26-37. doi:10.1038/nrurol.2016.251.

7. Kimura T, Sato S, Takahashi H, Egawa S.Global Trends of Latent Prostate Cancer in Autopsy Studies. Cancers (Basel). 2021;13(2):359. doi:10.3390/cancers13020359.

8. James ND, Tannock I, N'Dow J, et al. The Lancet Commission on prostate cancer: planning for the surge in cases. Lancet. 2024;403(10437):1683-722. doi:10.1016/S0140-6736(24)00651-2. Erratum in: Lancet. 2024;403(10437):1634. doi:10.1016/S0140-6736(24)00748-7.

9. Malignant neoplasms in Russia in 2023 (morbidity and mortality). Edited by A.D. Kaprin, et al. Moscow: P.A. Herzen Moscow State Medical Research Institute — branch of the Federal State Budgetary Institution "NMITS of Radiology" of the Ministry of Health of the Russian Federation, 2024. 276 p. (In Russ.)

10. The state of oncological care for the Russian population in 2024. Edited by A.D. Kaprin et al. Moscow: P.A. Herzen Moscow Institute of Medical Sciences — branch of the Federal State Budgetary Institution "NMITS of Radiology" of the Ministry of Health of the Russian Federation, 2025. 275 p. (In Russ.)

11. Wilson JM, Jungner YG. Principios y metodos del examen colectivo para identificar enfermedades [Principles and practice of mass screening for disease]. Bol Oficina Sanit Panam. 1968;65(4):281-393. Spanish.

12. Drapkina O.М., Samorodskaya I.V. Screening: terminology, principles and international experience. Preventive medicine. 2019;22(1):90-7. (In Russ.) Драпкина О.М., Самородская И.В. Скрининг: терминология, принципы и международный опыт. Профилактическая медицина. 2019;22(1):90-7. doi:10.17116/profmed20192201190.

13. Martin RM, Turner EL, Young GJ, et al.; CAP Trial Group. Prostate-Specific Antigen Screening and 15-Year Prostate Cancer Mortality: A Secondary Analysis of the CAP Randomized Clinical Trial. JAMA. 2024;331(17):1460-70. doi:10.1001/jama.2024.4011.

14. De Vrieze M, Hübner A, Al-Monajjed R, et al. Das Prostatakarzinom-Screening — aktueller Überblick [Prostate cancer screening-current overview]. Radiologie (Heidelb). 2024;64(6):479-87. German. doi:10.1007/s00117-024-01312-1. Erratum in: Radiologie (Heidelb). 2024;64(7):545. doi:10.1007/s00117-024-01329-6.

15. Hugosson J, Roobol MJ, Månsson M, et al.; ERSPC investigators. A 16-yr Followup of the European Randomized study of Screening for Prostate Cancer. Eur Urol. 2019;76(1):43-51. doi:10.1016/j.eururo.2019.02.009.

16. Loeb S, Gonzalez CM, Roehl KA, et al. Pathological characteristics of prostate cancer detected through prostate specific antigen based screening. J Urol. 2006;175(3 Pt 1):902-6. doi:10.1016/S0022-5347(05)00327-7.

17. Heijnsdijk EA, Wever EM, Auvinen A, et al. Quality-of-life effects of prostatespecific antigen screening. N Engl J Med. 2012;367(7):595-605. doi:10.1056/NEJMoa1201637.

18. Ilic D, Djulbegovic M, Jung JH, et al. Prostate cancer screening with prostatespecific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 2018;362:k3519. doi:10.1136/bmj.k3519.

19. Schröder FH, Roobol MJ. ERSPC and PLCO prostate cancer screening studies: what are the differences? Eur Urol. 2010;58(1):46-52. doi:10.1016/j.eururo.2010.03.033.

20. Hugosson J, Godtman RA, Carlsson SV, 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. 2018;52(1):27-37. doi:10.1080/21681805.2017.1411392.

21. Frånlund M, Månsson M, Godtman RA, et al. Results from 22 years of Followup in the Göteborg Randomized Population-Based Prostate Cancer Screening Trial. J Urol. 2022;208(2):292-300. doi:10.1097/JU.0000000000002696.

22. Ankerst DP, Hoefler J, Bock S, et al. Prostate Cancer Prevention Trial risk calculator 2.0 for the prediction of low- vs high-grade prostate cancer. Urology. 2014;83(6):1362-7. doi:10.1016/j.urology.2014.02.035.

23. Sergeeva NS, Skachkova TE, Marshutina NV, et al. The clinical significance of PSA-associated tests in the diagnosis and staging of prostate cancer. Oncology. P.A. Herzen Journal. 2018;(1):55-63. (In Russ.) doi:10.17116/onkolog20187155-67.

24. Bandala-Jacques A, Castellanos Esquivel KD, et al. Prostate Cancer Risk Calculators for Healthy Populations: Systematic Review. JMIR Cancer. 2021;7(3):e30430. doi:10.2196/30430.

25. Fazekas T, Shim SR, Basile G, Baboudjian M, et al. Magnetic Resonance Imaging in Prostate Cancer Screening: A Systematic Review and Meta-Analysis. JAMA Oncol. 2024;10(6):745-54. doi:10.1001/jamaoncol.2024.0734.

26. Kasivisvanathan V, Rannikko AS, Borghi M, et al.; PRECISION Study Group Collaborators. MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis. N Engl J Med. 2018;378(19):1767-77. doi:10.1056/NEJMoa1801993.

27. Nordström T, Discacciati A, Bergman M, et al.; STHLM3 study group. Prostate cancer screening using a combination of risk-prediction, MRI, and targeted prostate biopsies (STHLM3-MRI): a prospective, population-based, randomised, open-label, non-inferiority trial. Lancet Oncol. 2021;22(9):1240-9. doi:10.1016/S1470-2045(21)00348-X.

28. Ahn H, Park MY, Shin JI, et al. Fast Biparametric Versus Multiparametric Magnetic Resonance Imaging for Triage of Men with Elevated Prostate-specific Antigen: The PRO-TRIAGE Prospective Comparative Trial. Eur Urol Oncol. 2026;9(2):320-7. doi:10.1016/j.euo.2025.07.001.

29. US Preventive Services Task Force; Grossman DC, Curry SJ, Owens DK, et al. Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(18):1901-13. doi:10.1001/jama.2018.3710. Erratum in: JAMA. 2018;319(23):2443. doi:10.1001/jama.2018.7453.

30. Steinberg G.D., Carter B. S., Beaty T.H. et al. Family history and the risk of prostate cancer. Prostate 1990;17:337-437.

31. Stewart RW, Lizama S, Peairs K, et al. Screening for prostate cancer. Semin Oncol. 2017;44(1):47-56. doi:10.1053/j.seminoncol.2017.02.001.

32. Hemminki K.Familial risk and familial survival in prostate cancer. World J Urol. 2012;30(2):143-8. doi:10.1007/s00345-011-0801-1.

33. Randazzo M, Müller A, Carlsson S, et al. A positive family history as a risk factor for prostate cancer in a population-based study with organised prostate-specific antigen screening: results of the Swiss European Randomised Study of Screening for Prostate Cancer (ERSPC, Aarau). BJU Int. 2016;117(4):576-83. doi:10.1111/bju.13310.

34. Kensler KH, Johnson R, Morley F, et al. Prostate cancer screening in African American men: a review of the evidence. J Natl Cancer Inst. 2024;116(1):34-52. doi:10.1093/jnci/djad193.

35. Page EC, Bancroft EK, Brook MN, et al. Interim Results from the IMPACT Study: Evidence for Prostate-specific Antigen Screening in BRCA2 Mutation Carriers. Eur Urol. 2019;76(6):831-42. doi:10.1016/j.eururo.2019.08.019.

36. Bancroft EK, Page EC, Castro E, et al.; IMPACT Collaborators. Targeted prostate cancer screening in BRCA1 and BRCA2 mutation carriers: results from the initial screening round of the IMPACT study. Eur Urol. 2014;66(3):489-99. doi:10.1016/j.eururo.2014.01.003. Erratum in: Eur Urol. 2015;67(6):e126. doi:10.1016/j.eururo.2014.12.001.

37. Pritchard CC, Mateo J, Walsh MF, et al. Inherited DNA-Repair Gene Mutations in Men with Metastatic Prostate Cancer. N Engl J Med. 2016;375(5):443-53. doi:10.1056/NEJMoa1603144.

38. Nicolosi P, Ledet E, Yang S, et al. Prevalence of Germline Variants in Prostate Cancer and Implications for Current Genetic Testing Guidelines. JAMA Oncol. 2019;5(4):523-8.

39. Lowenstein LM, et al. Active surveillance for prostate and thyroid cancers: evolution in clinical paradigms and lessons learned. Nat Rev Clin Oncol. 2019 Mar;16(3):168-84. doi:10.1038/s41571-018-0116-x.

40. Wang MC, Valenzuela LA, Murphy GP, Chu TM. Purification of a human prostate specific antigen. Invest Urol. 1979;17(2):159-63.

41. Hara M, Koyanagi Y, Inoue T, Fukuyama T. [Some physico-chemical characteristics of " -seminoprotein", an antigenic component specific for human seminal plasma. Forensic immunological study of body fluids and secretion. VII]. Nihon Hoigaku Zasshi. 1971 25(4):322-4. Japanese.

42. Hara M, Inoue T, Koyanagi Y, Gotoh J, Yamazaki H, Fukuyama T.Preparation and immunoelectrophoretic assessment of antisera to human seminal plasma. Nippon Hoigaku Zasshi. 1966;20:356. (Abstract in Japanese);

43. Ablin RJ, Bronson P, Soanes WA, Witebsky E. Tissue- and species-specific antigens of normal human prostatic tissue. J Immunol. 1970;104(6):1329-39.

44. Li TS, Beling CG. Isolation and characterization of two specific antigens of human seminal plasma. Fertil Steril. 1973;24(2):134-44. doi:10.1016/s0015-0282(16)39496-1.

45. Catalona WJ. History of the discovery and clinical translation of prostate-specific antigen. Asian J Urol. 2014;1(1):12-4. doi:10.1016/j.ajur.2014.09.008.

46. Сatalona WJ, Smith DS, Ratliff TL, et al. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med. 1991;324(17):1156-116;

47. Kouriefs C, Sahoyl M, Grange P, Muir G.Prostate specific antigen through the years. Arch Ital Urol Androl. 2009;81(4):195-8.

48. Stephan C, Rittenhouse H, Hu X, Cammann H, Jung K.Prostate-Specific Antigen (PSA) Screening and New Biomarkers for Prostate Cancer (PCa). EJIFCC. 2014;25(1):55-78.

49. Diamandis EP, Yu H. Nonprostatic sources of prostate-specific antigen. Urol Clin North Am. 1997;24(2):275-82.

50. Stamey TA, Yang N, Hay AR, et al. Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med. 1987;317(15):909-16. doi:10.1056/NEJM198710083171501.

51. Nosov A.K. Early detection of prostate cancer. Practical oncology. 2010;11(2):74-80. (In Russ.)

52. Andriole GL, Crawford ED, Grubb RL, et al. PLCO Project Team. Mortality results from a randomized prostate-cancer screening trial. N Engl J Med. 2009;360(13):1310-9. doi:10.1056/NEJMoa0810696.

53. 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. Lancet. 2014;384(9959):2027-35. doi:10.1016/S0140-6736(14)60525-0.

54. Pinsky PF, Miller E, Prorok P, et al. Extended follow-up for prostate cancer incidence and mortality among participants in the Prostate, Lung, Colorectal and Ovarian randomized cancer screening trial. BJU Int. 2019;123(5):854-60. doi:10.1111/bju.14580.

55. Catalona WJ. Prostate Cancer Screening. Med Clin North Am. 2018;102(2):199-214. doi:10.1016/j.mcna.2017.11.001.

56. Martin RM, Donovan JL, Turner EL, et al. Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial. JAMA. 2018;319(9):883-95. doi:10.1001/jama.2018.0154.

57. Babaian RJ, Johnston DA, Naccarato W, et al. The incidence of prostate cancer in a screening population with a serum prostate specific antigen between 2.5 and 4.0 ng./ml.: relation to biopsy strategy. J Urol. 2001;165(3):757-60.

58. Meeks JJ, Loeb S, Helfand BT, et al. Characteristics of prostate cancers detected at prostate specific antigen levels less than 2.5 ng/ml. J Urol. 2009;181(6):2515-8; discussion 2518-9. doi:10.1016/j.juro.2009.01.102.

59. Ilic D, Neuberger MM, Djulbegovic M, Dahm P. Screening for prostate cancer. Cochrane Database Syst Rev. 2013;2013(1):CD004720. doi:10.1002/14651858.CD004720.pub3.

60. 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):2239-46.

61. Vietri MT, D'Elia G, Caliendo G, et al. Hereditary Prostate Cancer: Genes Related, Target Therapy and Prevention. Int J Mol Sci. 2021;22(7):3753. doi:10.3390/ijms22073753.

62. Khatami F, Afsari R, Khajavi A, Aghamir SMK. Age limit for familial prostate cancer screening. Caspian J Intern Med. 2024;16(1):187-91. doi:10.22088/cjim.16.1.187.

63. Richie JP, Catalona WJ, Ahmann FR, et al. Effect of patient age on early detection of prostate cancer with serum prostate-specific antigen and digital rectal examination. Urology. 1993;42(4):365-74. doi:10.1016/0090-4295(93)90359-i.

64. 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):835-9.

65. Gosselaar C, Roobol MJ, Roemeling S, Schröder FH. The role of the digital rectal examination in subsequent screening visits in the European randomized study of screening for prostate cancer (ERSPC), Rotterdam. Eur Urol. 2008;54(3):581-8. doi:10.1016/j.eururo.2008.03.104.

66. Herrera-Caceres JO, Wettstein MS, Goldberg H, et al. Utility of digital rectal examination in a population with prostate cancer treated with active surveillance. Can Urol Assoc J. 2020;14(9):E453-E457. doi:10.5489/cuaj.6341.

67. Okotie OT, Roehl KA, Han M, et al. Characteristics of prostate cancer detected by digital rectal examination only. Urology. 2007;70(6):1117-20. doi:10.1016/j.urology.2007.07.019.

68. Bratan F, Niaf E, Melodelima C, et al. Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study. Eur Radiol. 2013;23(7):2019-29. doi:10.1007/s00330-013-2795-0.

69. Barentsz JO, Richenberg J, Clements R, et al.; European Society of Urogenital Radiology. ESUR prostate MR guidelines 2012. Eur Radiol. 2012;22(4):746-57. doi:10.1007/s00330-011-2377-y.

70. Magnetta MJ, Casalino D, Heller MT. Imaging assessment of local recurrence of prostate cancer after radical prostatectomy. Abdom Radiol (New York). 2020;45(12):4073-83. doi:10.1007/s00261-020-02505-7.

71. Panebianco V, Villeirs G, Weinreb JC, et al. Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR): International Consensus -based Guidelines on Multiparametric Magnetic Resonance Imaging for Prostate Cancer Recurrence after Radiation Therapy and Radical Prostatectomy. Eur Urol Oncol. 2021;4(6):868-76. doi:10.1186/s13014-016-0671-1.

72. Allen SD, Thompson A, Sohaib SA. The normal post-surgical anatomy of the male pelvis following radical prostatectomy as assessed by magnetic resonance imaging. Eur Radiol. 2008;18(6):1281-91. doi:10.1007/s00330-008-0867-3.

73. Mertan FV, Greer MD, Borofsky S, et al. Multiparametric Magnetic Resonance Imaging of Recurrent Prostate Cancer. Top Magn Reson Imaging. 2016;25(3):139-47. doi:10.1097/RMR.0000000000000088.

74. Mishchenko AV, Rubtsova NA, Alekseev BYa, et al. A system of a unified approach to interpreting prostate magnetic resonance imaging according to the PI-RADSv2 guideline. Oncourology. 2016;12(1):81-9. (In Russ.) doi:10.17650/1726-9776-2016-12-1-81-89.

75. Patel P, Mathew MS, Trilisky I, Oto A. Multiparametric MR Imaging of the Prostate after Treatment of Prostate Cancer. Radiographics. 2018;38(2):437-49. doi:10.1148/rg.2018170147.

76. Kowa JY, Soneji N, Sohaib SA, et al. Detection and staging of radio-recurrent prostate cancer using multiparametric MRI. Br J Radiol. 2021;94(1120):20201423. doi:10.1259/bjr.20201423.

77. Rubtsova NA, Mishchenko AV, Danilov VV, et al. PI-RADS v2.1: movement towards clarity (comments to the updated version). Oncourology. 2020;16(2):15-28. (In Russ.) doi:10.17650/1726-9776-2020-16-2-15-28.

78. Eklund M, Jäderling F, Discacciati Aet al.; STHLM3 consortium. MRI-Targeted or Standard Biopsy in Prostate Cancer Screening. N Engl J Med. 2021;385(10):908-20. doi:10.1056/NEJMoa2100852.

79. Eldred-Evans D, Ahmed HU. Population-Based Prostate Cancer Screening With Magnetic Resonance Imaging or Ultrasonography-The IP1-PROSTAGRAM StudyReply. JAMA Oncol. 2021;7(10):1575-6. doi:10.1001/jamaoncol.2021.2967.

80. Turkbey B, Rosenkrantz AB, Haider MA, et al. Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2. Eur Urol. 2019;76(3):340-51. doi:10.1016/j.eururo.2019.02.033.

81. Correas JM, Halpern EJ, Barr RG, et al. Advanced ultrasound in the diagnosis of prostate cancer. World J Urol. 2021;39(3):661-76. doi:10.1007/s00345-020-03193-0.

82. Haider M, Leow JJ, Nordström T, et al. Emerging tools for the early detection of prostate cancer. BJUI Compass. 2025;6(9):e70081. doi:10.1002/bco2.70081.

83. Grey ADR, Scott R, Shah B, et al. Multiparametric ultrasound versus multiparametric MRI to diagnose prostate cancer (CADMUS): a prospective, multicentre, pairedcohort, confirmatory study. Lancet Oncol. 2022;23(3):428-38. doi:10.1016/S1470-2045(22)00016-X.

84. Alghamdi D, Kernohan N, Li C, Nabi G. Comparative Assessment of Different Ultrasound Technologies in the Detection of Prostate Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel). 2023;15(16):4105. doi:10.3390/cancers15164105.

85. Liu D, Lin W, Wei C, et al. Exploring the potential clinical value of shear wave elastography in prostate cancer: a meta-analysis. BMC Cancer. 2025;25(1):1032. doi:10.1186/s12885-025-14414-3.

86. Kinnaird A, Luger F, Cash H, et al.; OPTIMUM Investigators. MicroultrasonographyGuided vs MRI-Guided Biopsy for Prostate Cancer Diagnosis: The OPTIMUM Randomized Clinical Trial. JAMA. 2025;333(19):1679-87. doi:10.1001/jama.2025.3579.

87. Kadrev A.V., Mitkova M.D., Amosov A.V., Bulanov M.N., Vetsheva N.N., Gromov A.I., Ignashin N.S., Krupinov G.E., Mitina L.A., Sorokin N.I., Strokova L.A., Khitrova A.N., Shvyrev S.L., Mitkov V.V. Recommendations for prostate ultrasound in adults. Part II. Transrectal prostate ultrasound. An expert consensus statement from the Russian Association of Specialists in Ultrasound Diagnostics in Medicine (RASUDM). Ultrasound & Functional Diagnostics. 2023;(3):9-23. (In Russ.) doi:10.24835/1607-0771-2023-3-9-23.

88. Rifkin MD, Dahnert W, Kurtz AB. State of the art: endorectal sonography of the prostate gland. AJR Am.J. Roentgenol. 1990;154(4):691-700. doi:10.2214/ajr.154.4.1690499.

89. Barr RG, Cosgrove D, Brock M, et al. WFUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography: Part 5. Prostate. Ultrasound Med Biol. 2017;43(1):27-48. doi:10.1016/j.ultrasmedbio.2016.06.020.

90. Săftoiu A, Gilja OH, Sidhu PS, et al. The EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018. Ultraschall Med. 2019;40(4):425-53. English. doi:10.1055/a-0838-9937.

91. Kadrev A.V., Mitkova M.D., Kamalov A.A., Mitkov V.V. Multiparametric ultrasound in prostate cancer diagnosis. Ultrasound & Functional Diagnostics. 2021;(3):37-70. (In Russ.) doi:10.24835/1607-0771-2021-3-37-70.

92. Catalona WJ, Partin AW, Slawin KM, et al. Use of the Percentage of Free Prostate-Specific Antigen to Enhance Differentiation of Prostate Cancer From Benign Prostatic DiseaseUse of the percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA. 1998;279(19):1542-7.

93. Partin AW, Brawer MK, Subong EN, et al. Prospective evaluation of percent freePSA and complexed-PSA for early detection of prostate cancer. Prostate Cancer Prostatic Dis. 1998;1(4):197-203. doi:10.1038/sj.pcan.4500232.

94. Benson MC, Whang IS, Pantuck A, et al. WH. Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer. J Urol. 1992;147(3 Pt 2):815-6.

95. Pushkar DYu, Govorov AV, Sidorenkov AV, et al. Early diagnosis of prostate cancer. Methodological recommendations No. 19. Moscow: ABC-Press Publishing House, 2015. 52 p. (In Russ.)

96. Mikolajczyk SD, Grauer LS, Millar LS, et al. A precursor form of PSA (pPSA) is a component of the free PSA in prostate cancer serum. Urology. 1997;50(5):710-4. doi:10.1016/S0090-4295(97)00449-4.

97. Catalona WJ, Bartsch G, Rittenhouse HG, et al. Serum pro-prostate specific antigen preferentially detects aggressive prostate cancers in men with 2 to 4 ng/ml prostate specific antigen. J Urol. 2004;171(6 Pt 1):2239-44.

98. Catalona WJ, Partin AW, Sanda MG, et al. A multicenter study of [-2]pro-prostate specific antigen combined with prostate specific antigen and free prostate specific antigen for prostate cancer detection in the 2.0 to 10.0 ng/ml prostate specific antigen range. J Urol. 2011;185(5):1650-5. doi:10.1016/j.juro.2010.12.032.

99. Guazzoni G, Lazzeri M, Nava L, et al. Preoperative prostate-specific antigen isoform p2PSA and its derivatives, %p2PSA and prostate health index, predict pathologic outcomes in patients undergoing radical prostatectomy for prostate cancer Eur Urol. 2012;61(3):455-66. doi:10.1016/j.eururo.2011.10.038.

100. Stephan C, Vincendeau S, Houlgatte A, et al. Multicenter evaluation of [-2] proprostate-specific antigen and the prostate health index for detecting prostate cancer. Clin Chem. 2013;59(1):306-14. doi:10.1373/clinchem.2012.195784.

101. Ruzhanskaya AV, Evgenina SA, Skibo II. Practical use of marker -2props and prostate health index phi in the diagnosis of prostate cancer Clinical laboratory diagnostics. 2014;(1):4-8. (In Russ.)

102. Rapoport LM, Bezrukov EA, Sukhanov RB, et al. Biomarkers for diagnosing of prostate cancer: the present and the future. Andrology and Genital Surgery. 2018;19(1):68-76. (In Russ.) doi:10.17650/2070-9781-2018-19-1-68-76.

103. Fradet Y, Saad F, Aprikian A, et al. uPM3, a new molecular urine test for the detection of prostate cancer. Urology. 2004;64(2):311-5. doi:10.1016/j.urology.2004.03.052.

104. Aboian IA, Fedotova EN, Shevchenko AN, et al. Current biomarkers of prostate cancer. Research and Practical Medicine Journal. 2021;8(4):96-108. (In Russ.) doi:10.17709/2410-1893-2021-8-4-10.

105. Popov SV, Guseynov RG, Vasin AV, et al. Current understanding of prostate cancer biomarkers. Cancer Urology. 2023;19(4):148-57. (In Russ.) doi:10.17650/1726-9776-2023-19-4-148-157.

106. Vickers AJ, Cronin AM, Aus G, et al. A panel of kallikrein markers can reduce unnecessary biopsy for prostate cancer: data from the European Randomized Study of Prostate Cancer Screening in Göteborg, Sweden. BMC Med. 2008;6:19. doi: 10.1186/1741-7015-6-19.

107. Parekh DJ, Punnen S, Sjoberg DD, et al. A multi-institutional prospective trial in the USA confirms that the 4Kscore accurately identifies men with high-grade prostate cancer. Eur Urol 2015;68(3):464-70. doi:10.1016/j.eururo.2014.10.021.

108. Kanwal R, Plaga AR, Liu X, et al. MicroRNAs in prostate cancer: Functional role as biomarkers. Cancer Lett. 2017;407:9–20. doi:10.1016/j.canlet.2017.08.011.

109. Sharma N, Baruah MM. The microRNA signatures: aberrantly expressed miRNAs in prostate cancer. Clin Transl Oncol. 2019;21(2):126-44. doi:10.1007/s12094-018-1910-8.

110. Bautista-Sánchez D., Arriaga-Canon C., Pedroza-Torres A. et al. The promising role of miR-21 as a cancer biomarker and its importance in RNA-based therapeutics. Mol Ther Nucleic Acids. 2020;20:409-20. doi:10.1016/j.omtn.2020.03.003.

111. Spratt DE, Srinivas S, Adra N, et al. Prostate Cancer, Version 3.2026, NCCN Clinical Practice Guidelines In Oncology. J Natl Compr Canc Netw. 2025;23(11):469-93. doi:10.6004/jnccn.2025.0052.

112. Jain MA, Leslie SW, Sapra A. Prostate Cancer Screening. [Updated 2023 Oct 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556081.

113. Sarkar RR, Parsons JK, Bryant AK, et al. Association of Treatment With 5αReductase Inhibitors With Time to Diagnosis and Mortality in Prostate Cancer. JAMA Intern Med. 2019;179(6):812-9. doi:10.1001/jamainternmed.2019.0280.

114. Andriole GL, Guess HA, Epstein JI, et al. Treatment with finasteride reserves usefulness of prostate-specific antigen in the detection of prostate cancer: results of a randomized, double-blind, placebo-controlled clinical trial. PLESS Study Group. Proscar Long-term Efficacy and Safety Study. Urology. 1998;52(2):195-201. doi:10.1016/S0090-4295(98)00184-8.

115. Andriole GL, Bostwick DG, Brawley OW, et al.; REDUCE Study Group. Effect of dutasteride on the risk of prostate cancer. N Engl J Med. 2010;362(13):1192-202. doi:10.1056/NEJMoa0908127.

116. Lilja H, Cronin A.M, Dahlin A, et al. Prediction of significant prostate cancer diagnosed 20 to 30 years later with a single measure of prostate-specific antigen at or before age 50. Cancer. 2011;117(6):1210-9. doi:10.1002/cncr.25568.

117. Kovac E, Carlsson SV, Lilja H, et al. Association of Baseline Prostate-Specific Antigen Level With Long-term Diagnosis of Clinically Significant Prostate Cancer Among Patients Aged 55 to 60 Years. JAMA Netw Open. 2020;3(1):e1919284. doi:10.1001/jamanetworkopen.2019.19284.

118. Carter HB. Prostate cancers in men with low PSA levels — must we find them? N Engl J Med. 2004;350(22):2292-4. doi:10.1056/NEJMe048003.

119. Albright F, Stephenson RA, Agarwal N, et al. Prostate cancer risk prediction based on complete prostate cancer family history. Prostate. 2015;75(4):390-8. doi:10.1002/pros.22925.

120. Grill S, Fallah M, Leach RJ, et al. Incorporation of detailed family history from the Swedish Family Cancer Database into the PCPT risk calculator. J Urol. 2015;193:460-5. doi:10.1016/j.juro.2014.09.018.

121. Franz T, Stolzenburg JU. Clinical Relevance of Digital Rectal Examination in Men With Low and Very Low Prostate-Specific Antigen (PSA): Reassessing Its Diagnostic Value in the MRI Era and in Light of Modern Guidelines. Cureus. 2025;17(12):e99145. doi:10.7759/cureus.99145.

122. Thompson IM, Ankerst DP, Chi C, et al. Operating characteristics of prostatespecific antigen in men with an initial PSA level of 3.0 ng/ml or lower. JAMA. 2005;294(1):66-70. doi:10.1001/jama.294.1.66.

123. Leitzmann MF, Rohrmann S.Risk factors for the onset of prostatic cancer: age, location, and behavioral correlates. Clin Epidemiol. 2012;4:1-11. doi:10.2147/CLEP.S16747.

124. Mano R, Tamir S, Kedar I, et al. Malignant Abnormalities in Male BRCA Mutation Carriers: Results From a Prospectively Screened Cohort. JAMA Oncol. 2018;4(6):872-4. doi:10.1001/jamaoncol.2018.0271.

125. Carroll PR, Parsons JK, Andriole GL, et al. NCCN Guidelines Insights: Prostate Cancer Early Detection, Version 2.2016. J Natl Compr Canc Netw. 2016;14(5):509-19. doi:10.6004/jnccn.2016.0060.

126. Wen J, Liu W, Shen X, Hu W. PI-RADS v2.1 and PSAD for the prediction of clinically significant prostate cancer among patients with PSA levels of 4-10 ng/ml. Sci Rep. 2024;14(1):6570. doi:10.1038/s41598-024-57337-y.

127. Li Y, Wang S, Wang J, et al. PI-RADSv2.1 combined with PSA density for optimizing prostate biopsy decisions: a retrospective analysis. Front Oncol. 2025;15:1602412. doi:10.3389/fonc.2025.1602412.

128. Ahmed HU, El-Shater Bosaily A, Brown LC, et al. Diagnostic accuracy of multiparametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017;389:815-22. doi:10.1016/S0140-6736(16)32401-1.

129. Elkhoury FF, Felker ER, Kwan L, et al. Comparison of Targeted vs Systematic Prostate Biopsy in Men Who Are Biopsy Naive: The Prospective Assessment of Image Registration in the Diagnosis of Prostate Cancer (PAIREDCAP) Study. JAMA Surg. 2019;154(9):811-8. doi:10.1001/jamasurg.2019.1734.

130. Ahdoot M, Wilbur AR, Reese SE, et al. MRI-Targeted, Systematic, and Combined Biopsy for Prostate Cancer Diagnosis. N Engl J Med. 2020;382(10):917-28. doi:10.1056/NEJMoa1910038.

131. Adhyam M, Gupta AK. A Review on the Clinical Utility of PSA in Cancer Prostate. Indian J Surg Oncol. 2012;3(2):120-9. doi:10.1007/s13193-012-0142-6.

132. Herschman JD, Smith DS, Catalona WJ. Effect of ejaculation on serum total and free prostate-specific antigen concentrations. Urology. 1997;50(2):239-43. doi:10.1016/S0090-4295(97)00209-4.

133. Mejak SL, Bayliss J, Hanks SD. Long distance bicycle riding causes prostate-specific antigen to increase in men aged 50 years and over. PLoS One. 2013;8(2):e56030. doi:10.1371/journal.pone.0056030.

134. Oremek GM, Seiffert UB. Physical activity releases prostate-specific antigen (PSA) from the prostate gland into blood and increases serum PSA concentrations. Clin Chem. 1996;42(5):691-5.

135. Stimac G, Spajic B, Reljic A, et al. Effect of histological inflammation on total and free serum prostate-specific antigen values in patients without clinically detectable prostate cancer. Korean J Urol. 2014;55(8):527-32. doi:10.4111/kju.2014.55.8.527.

136. Kawakami J, Siemens DR, Nickel JC. Prostatitis and prostate cancer: implications for prostate cancer screening. Urology. 2004;64:1075. doi:10.1016/j.urology.2004.07.017.

137. Effect of digital rectal examination on serum prostate-specific antigen in a primary care setting. The Internal Medicine Clinic Research Consortium. Arch Intern Med. 1995;155(4):389-92.

138. Yuan JJ, Coplen DE, Petros JA, et al. Effects of rectal examination, prostatic massage, ultrasonography and needle biopsy on serum prostate specific antigen levels. J Urol. 1992;147(3 Pt 2):810-4. doi:10.1016/s0022-5347(17)37392-5.

139. Chybowski FM, Bergstralh EJ, Oesterling JE. The effect of digital rectal examination on the serum prostate specific antigen concentration: results of a randomized study. J Urol. 1992;148(1):83-6. doi:10.1016/s0022-5347(17)36517-5.

140. Bossens MM, Van Straalen JP, De Reijke TM, et al. Kinetics of prostate-specific antigen after manipulation of the prostate. Eur J Cancer. 1995;31A(5):682-5. doi:10.1016/0959-8049(95)00016-c.

141. Lechevallier E, Eghazarian C, Ortega JC, et al. Effect of digital rectal examination on serum complexed and free prostate-specific antigen and percentage of free prostatespecific antigen. Urology. 1999;54(5):857-61. doi:10.1016/s0090-4295(99)00239-3.

142. Maccini MA, Westfall NJ, Van Bokhoven A, et al. The effect of digital rectal exam on the 4Kscore for aggressive prostate cancer. Prostate. 2018;78(7):506-11. doi:10.1002/pros.23495.

143. Klomp ML, Hendrikx AJ, Keyzer JJ. The effect of transrectal ultrasonography (TRUS) including digital rectal examination (DRE) of the prostate on the level of prostate specific antigen (PSA). Br J Urol. 1994;73(1):71-4. doi:10.1111/j.1464-410x.1994.tb07459.x.

144. Serel TA, Cetin M, Delibaş N, et al. Effect of transrectal ultrasonography of the prostate on serum prostate-specific antigen levels and free/total prostate-specific antigen ratio. Urol Int. 2000;64(1):24-6. doi:10.1159/000030477.

145. Park SC, Shin YS, Zhang LT, et al. Prospective investigation of change in the prostate-specific antigens after various urologic procedures. Clin Interv Aging. 2015;10:1213-8. doi:10.2147/CIA.S84570.

146. Klein LT, Lowe FC. The effects of prostatic manipulation on prostate-specific antigen levels. Urol Clin North Am. 1997;24(2):293-7. doi:10.1016/s0094-0143(05)70375-x.

147. Oesterling JE, Rice DC, Glenski WJ, Bergstralh EJ. Effect of cystoscopy, prostate biopsy, and transurethral resection of prostate on serum prostate-specific antigen concentration. Urology. 1993;42(3):276-82. doi:10.1016/0090-4295(93)90616-i.

148. Cetinkaya ZA, Sezikli M, G zelbulut F, et al. Serum levels of prostate specific antigen are elevated after colonoscopy. Tohoku J Exp Med. 2010;222(3):183-6. doi:10.1620/tjem.222.183.