Overdiagnosis and Overtreatment in Prostate Cancer
Dushimova Z. Iztleuov Y. Chingayeva G. Shepetov A. Mustapayeva N. Shatkovskaya O. Pashimov M. Saliev T.
June 2025Multidisciplinary Digital Publishing Institute (MDPI)
Diseases
2025#13Issue 6
Prostate cancer (PCa) is one of the most common malignancies among men worldwide. While prostate-specific antigen (PSA) screening has improved early detection, it has also led to significant challenges regarding overdiagnosis and overtreatment. Overdiagnosis involves identifying indolent tumors unlikely to affect a patient’s lifespan, while overtreatment refers to unnecessary interventions that can cause adverse effects such as urinary incontinence, erectile dysfunction, and a reduced quality of life. This review highlights contributing factors, including the limitations of PSA testing, advanced imaging techniques like multi-parametric MRI (mpMRI), medical culture, and patient expectations. The analysis emphasizes the need for refining screening protocols, integrating novel biomarkers (e.g., PCA3, TMPRSS2-ERG), and adopting conservative management strategies such as active surveillance to minimize harm. Risk-based screening and shared decision-making are critical to balancing the benefits of early detection with the risks of unnecessary treatment. Additionally, systemic healthcare factors like financial incentives and malpractice concerns exacerbate overuse. This review advocates for updated clinical guidelines and personalized approaches to optimizing patient outcomes while reducing the strain on healthcare resources. Addressing overdiagnosis and overtreatment through targeted interventions will improve the quality of life for PCa patients and enhance the efficiency of healthcare systems.
cancer treatment , healthcare resources , overdiagnosis , overtreatment , prostate cancer , PSA screening
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Department of Fundamental Medicine, Al-Farabi Kazakh National University, Almaty, 050040, Kazakhstan
NJSC “Marat Ospanov West Kazakhstan Medical University”, Aktobe, 030019, Kazakhstan
S.D. Asfendiyarov Kazakh National Medical University, Tole Bi Street 94, Almaty, 050000, Kazakhstan
National Research Oncology Center, Astana, 020000, Kazakhstan
JSC “Research Institute of Cardiology and Internal Diseases”, Almaty, 050000, Kazakhstan
Department of Fundamental Medicine
NJSC “Marat Ospanov West Kazakhstan Medical University”
S.D. Asfendiyarov Kazakh National Medical University
National Research Oncology Center
JSC “Research Institute of Cardiology and Internal Diseases”
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