Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2025.66.382
Feasibility and first-year findings of a pilot program of prostate cancer screening in Croatia (CROState)
Željko Kaštelan
; Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
Tomislav Kuliš
; Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
*
Igor Grubišić
; University of Zagreb School of Medicine, Zagreb, Croatia
Ivana Brkić Biloš
; Croatian Institute of Public Health, Zagreb, Croatia
Maja Prutki
; University of Zagreb School of Medicine, Zagreb, Croatia
Marija Bubaš
; Ministry of Health, Zagreb, Croatia
Krunoslav Capak
; University of Zagreb School of Medicine, Zagreb, Croatia
* Dopisni autor.
Sažetak
Aim To evaluate the feasibility, participation rate, diagnos
tic pathway performance, and early detection outcomes of
the first year of the Croatian pilot prostate cancer screen
ing program (CROState) implemented in Zagreb.
Methods This prospective pilot program invited men
aged 55-69 years without a prior prostate cancer diagno
sis or prostate-specific antigen (PSA) testing in the past 12
months. Recruitment was conducted by general practitio
ners. Men with PSA>4 ng/mL underwent repeat testing,
and if PSA was elevated again, they were referred to one
of two university hospitals for further evaluation. The diag
nostic pathway included multiparametric magnetic reso
nance imaging, urological examination, and transperineal
fusion biopsy when indicated. All confirmed cancer cases
were reviewed by a multidisciplinary team.
Results A total of 5251 men were invited to the program,
of whom 4930 (93.9%) participated in PSA testing. Elevat
ed PSA was detected in 419 (8.5%). Only 157 (37.5%) men
completed repeat PSA testing, and 123 men were referred
for hospital evaluation. Eighty-eight patients completed
advanced diagnostics, with 83 undergoing magnetic res
onance imaging. Forty-two men proceeded to biopsy, of
whom 27 had positive results (64.3%). Most cancers were
clinically significant; only two men fulfilled criteria for ac
tive surveillance. The main challenge was incomplete ad
herence to repeat PSA testing.
Conclusion The CROState pilot demonstrated high initial
participation and high detection rate of prostate cancer,
with a few clinically insignificant tumors, when combining
PSA testing with advanced imaging and targeted biopsy.
Limited compliance with repeat PSA testing must be ad
dressed before wider national implementation
Ključne riječi
Hrčak ID:
352557
URI
Datum izdavanja:
21.12.2025.
Posjeta: 0 *