Reference: 2026 | Issue 7 | Vol 12 | Page 50
The 41st Annual Congress of the European Association of Urology (EAU26), Europe’s largest urology conference, took place from 13-16 March, 2026, in London, UK. Around 2,000 abstracts were presented, covering subjects ranging from prostate, kidney, and bladder cancer to urinary incontinence and erectile dysfunction. The packed four-day scientific programme also included live surgery, state-of-the-art lectures, case discussions, and debates.
Prostate cancer screening compares favourably to breast cancer screening in identifying significant malignancies, reducing mortality, and avoiding unnecessary harms, according to new data presented at the European Association of Urology 2026 Congress. Similarities between the two forms of screening mean it is no longer rational to reject prostate cancer screening on one hand while endorsing screening for breast cancer on the other, delegates heard.
Although breast and prostate cancer are the most commonly diagnosed cancers in Europe amongst men and women, respectively, screening for the diseases is vastly different. Organised breast cancer screening programmes have been established across the continent for more than three decades. Prostate cancer screening has lagged behind, primarily due to concerns around the effectiveness of the prostate-specific antigen (PSA) blood test and the risks of overdiagnosis and overtreatment. Nevertheless, many men undergo variable, opportunistic screening for the disease, primarily based on self-referral.
The research, which was accepted for publication in European Urology, compared the two types of cancer screening in terms of the effectiveness of the diagnostic tests and levels of overdiagnosis. Investigators from the German Cancer Research Centre in Heidelberg, Germany, drew on data from both the PROBASE prostate cancer screening trial in Germany and the country’s breast cancer screening programme. They used data from 39,392 men who underwent an initial PSA blood test as part of the PROBASE trial at age 45 or 50. They compared this with data from just over 2.8 million women, aged 50-69, who had a mammography as part of Germany’s organised breast cancer screening programme. They found:
- PSA blood testing followed by an MRI scan leads to a higher number of false positives than mammography (37-42% vs 10%).
- A similar proportion of men and women were referred for biopsy (0.8-2.4% for men and 1.1% for women) as men in the PROBASE trial were triaged before referral using risk stratification.
- Biopsies were far more likely to identify significant cancer in prostate screening than in breast screening (50-68% vs 10%), indicating that fewer men were referred for biopsy unnecessarily.
- The percentages of invasive cancers identified were similar across both prostate and breast cancer screening (60-74% vs 73%).
- Prostate cancer screening was more likely to identify non-aggressive cancers than breast cancer screening (26-31% vs 22%). However, in prostate cancer, the option of active surveillance is well-established, and the researchers maintained this would limit the risk of overtreatment.
Dr Sigrid Carlsson, who leads Clinical Epidemiology of Early Cancer Detection at the German Cancer Research Centre in Heidelberg, led the research. She said: “Until we have a population-based screening programme for prostate cancer, we can’t make an exact like-for-like comparison with breast cancer. But we can make some informed assumptions based on the data from our trial, which shows that if prostate cancer screening were extended to the wider population, then the outcomes are likely to be very similar to breast cancer. Although our study used German data, the findings are applicable to other countries. The final question we now need to answer is: What will this cost compared to what we are already paying for opportunistic screening? And that work is already under way.”
