Smart Prostate Cancer Screening in the EU: From PRAISE-U to PRAISE-U+

Over the past three years, PRAISE-U has brought together 25 organisations from 10 countries with a shared goal: demonstrating how smart, risk-based prostate cancer screening can be implemented across Europe. What began as an ambitious vision has grown into one of the largest collaborative efforts in prostate cancer screening ever undertaken in Europe.  

Prof. Hein Van Poppel (BE), scientific lead for the EAU within PRAISE-U welcomed participants on behalf of himself and Prof. Monique Roobol (NL) with an overview of the policy and scientific landscape in prostate cancer screening in Europe. This was followed by updates from the Data Monitoring Committee, the quality control team for pathology and MRI images, as well as presentations from experts evaluating the project's clinical, psychosocial, and health economic outcomes. 

Over the course of the project, approximately 15,000 men participated in screening programmes across the five European pilot sites. The results presented during the meeting demonstrated that the multi-step screening pathway was effectively implemented in all sites with a compliance rate of more than 90% across the pathway, and participation rates ranged from 7.1– 43%. Data were successfully collected on the shared registry, showing an effective reduction in both MRI and biopsies.  

The project's psychosocial findings provided equally valuable insights. While participants do not experience increased stress throughout the screening process, there was an increase in anxiety during screening. These findings highlight the importance of communication and psychosocial support throughout the screening pathway.  

The project also employed Collaborative User Boards as an innovative way to discuss the impact of the screening pathway from a participant perspective. Each pilot site involved a range of stakeholders to provide their thoughts about the programme, ensuring that the screening algorithm was implemented with the participant and patient voices in mind. 

The results from PRAISE-U demonstrated that the adaptable algorithm is feasible and acceptable in multiple settings across the EU, successfully capturing the realities and needs of each pilot site. Dr. Roderick van den Bergh (NL) highlighted that the ideal screening algorithm is one that can be relied on across different contexts due to its flexibility and adaptability. He emphasised that moving towards opportunistic testing to systematic screening requires long-lasting behavioural and cultural change, which can only happen gradually and locally. 

The consortium meeting marked the conclusion of the PRAISE-U project, but it marks the beginning of a new phase for prostate cancer screening in Europe with the launch of PRAISE-U+. Building on the project's success, PRAISE-U+ has secured funding to expand the initiative into seven additional Member States, nearly doubling the size of the consortium and significantly increasing its reach across Europe. 

The follow-up project will establish 10 pilot sites, further refine quality assurance measures of the algorithm and generate evidence on the long-term sustainability of risk-based screening. Men who participated in the first screening wave during PRAISE-U will be invited for another round of screening to evaluate the sustainability of the pathway across multiple settings. The follow-up project will focus on improving access for underserved populations to prostate cancer screening and incorporate new technological advancements by making responsible use of AI in quality control.  

Another important area of investigation of PRAISE-U+ will be the widespread use of unorganised prostate cancer testing across Europe. According to Dr. Erik Briers (BE), chair of Europa Uomo, understanding these testing patterns is essential when moving towards organised screening programmes. “Reducing opportunistic screening without ensuring equity in access to organised screening for every man that should receive it could result in underdiagnosis and cost people's lives.” 

The story of PRAISE-U is ultimately a story of collaboration. By bringing together expertise from across Europe and aligning researchers, clinicians, policymakers and patient organisations around a common goal, the consortium has laid the foundations for a smarter and more equitable approach to prostate cancer screening. 

As PRAISE-U+ prepares for its official launch in November, the consortium can look back with pride on what has been achieved and look forward with confidence to what comes next. The foundations have been laid; the next phase begins now.

For more information, visit PRAISE-U.