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Prostate cancer screening based on prostate-specific antigen (PSA) testing has been a matter of controversy. Although screening for prostate cancer was effective in reducing mortality, it resulted in overdiagnosis, which translated into unnecessary treatments and numerous adverse effects. As a result, recommendations from scientific societies became increasingly restrictive. In the recent years, new approaches to prostate cancer screening have been proposed. These new approaches are aimed at solving the controversy between widespread screening vs. no screening, and reconsidering PSA testing as a screening tool with a good benefit/risk balance. In this context, the European Association of Urology submitted a proposal to the European Commission for prostate cancer screening to be performed as a function of baseline PSA concentrations. The European Commission recently recommended the implementation of organized prostate cancer screening programs for men aged ≤70 years based on PSA values in combination with follow-up magnetic resonance imaging.

El cribado del cáncer de próstata mediante la medida del antígeno específico de la próstata (PSA) ha sido objeto de una intensa polémica. Los beneficios derivados en cuanto a reducción en mortalidad del cribado organizado del cáncer de próstata se han acompañado de un importante sobrediagnóstico, que se ha traducido en tratamientos innecesarios y numerosos efectos adversos. Por ello, las recomendaciones de las sociedades científicas han sido cada vez más restrictivas. En los últimos años se han hecho diversas propuestas para reconsiderar el enfoque sobre el cribado del cáncer de próstata, con objeto de superar la oposición entre cribar a todo el mundo o no cribar a nadie y a reconsiderar el PSA como una herramienta que permita un balance favorable entre beneficios y riesgos. En este contexto, hay que destacar la propuesta que la European Association of Urology dirigía a la Comisión Europea replanteando el cribado del cáncer de próstata en función de la medida de un PSA basal. Recientemente, la Comisión Europea ha recomendado la implementación de programas organizados para el cribado del cáncer de próstata para hombres de hasta 70 años basado en medidas de PSA en combinación con la resonancia magnética como prueba de seguimiento.

Abstract Background Changes in DNA methylation of crucial cancer genes including tumor suppressors can occur early in carcinogenesis, being potentially important early indicators of cancer. The objective of this study was to examine a multiplexed approach to assess the methylation of tumor suppressor genes as tumor stratification and clinical outcome prognostic biomarkers for lung cancer. Methods A multicandidate probe panel interrogated DNA for aberrant methylation status in 18 tumor suppressor genes in lung cancer using a methylation-specific multiplex ligation-dependent probe amplification assay (MS-MLPA). Lung cancer cell lines (n = 7), and primary lung tumors (n = 54) were examined using MS-MLPA. Results Genes frequently methylated in lung cancer cell lines including SCGB3A1, ID4, CCND2 were found among the most commonly methylated in the lung tumors analyzed. HLTF, BNIP3, H2AFX, CACNA1G, TGIF, ID4 and CACNA1A were identified as novel tumor suppressor candidates methylated in lung tumors. The most frequently methylated genes in lung tumors were SCGB3A1 and DLC1 (both 50.0%). Methylation rates for ID4, DCL1, BNIP3, H2AFX, CACNA1G and TIMP3 were significantly different between squamous and adenocarcinomas. Methylation of RUNX3, SCGB3A1, SFRP4, and DLC1 was significantly associated with the extent of the disease when comparing localized versus metastatic tumors. Moreover, methylation of HTLF, SFRP5 and TIMP3 were significantly associated with overall survival. Conclusions MS-MLPA can be used for classification of certain types of lung tumors and clinical outcome prediction. This latter is clinically relevant by offering an adjunct strategy for the clinical management of lung cancer patients.