Prostate Cancer Screening With Abbreviated MRI Protocol

A prospective cross-sectional (with a longitudinal component, 2nd screening round) study evaluating the possibility of using the biparametric MRI protocol technique for screening clinically significant prostate cancer in men from the general population. Tests performed: * Serum PSA * PHI calculation (Prostate Health Index) to be performed only if the PSA values are in the range of 2-10 ng/l * MRI of the prostate (abbreviated biparametric protocol) * Digital rectal examination (DRE) as part of a clinical visit at a urologist in patients with a positive PSA test * Biopsy - if indicated MRI specifications: * Protocol with anatomical T2 sequence and diffusion-weighted images (DWI), according to the standards * Typical complete examination time does not exceed 20 minutes, planned acquisition time less than 15 minutes. * No contrast agent or spasmolytics is injected. Blinding: * Every test evaluator (radiologist/urologist) does not know the results of other tests. · MRI reports entered in the registry obligatorily before the biopsy. * The patient is not informed which test was positive and resulted in an indication for biopsy. * The pathologist does not know the results of MRI or laboratory tests. The sequence of tests: The MRI is assessed with the PI-RADS 2.1 system, each finding is reported on a scale of 1-5. To minimize the detection of non-significant cancers and to reduce the number of biopsies according to the results of the IP1-Prostagram study, a PI-RADS value of 4-5 was chosen as a positive test representation. Consensual double reading by 2 experienced uroradiologists (at least 400 MRI of the prostate read by the beginning of the study). Men with a positive MRI test are planned for a targeted MRI/US fusion and systematic prostate biopsy. Men with a positive blood marker (either PSA, PSAD, or PHI) are planned for a systematic 12 core biopsy. Positive test results are PSA ≥ 3, integrated marker PSAD ≥ 0.15, and PHI ≥ 35. Study participants are invited to repeat the screening tests after 2 years by letter. If they do not respond to a written offer, also by e-mail and SMS. Definition of clinically significant cancer: • ISUP Grade Group ≥ 2.