Journal: Aktuelle Urologie
This is a prospective, non-interventional, multicenter registry analysis from the VERSUS study of urological cancers documented by 200 German uro-oncology practices.
From May 2018 to August 2025, 31,419 patients with newly diagnosed urological malignancies were recorded, including 20,253 with prostate cancer. Median age at prostate cancer diagnosis was 70.3 years, and median PSA was 9 ng/mL (range 0–28,485 ng/mL).
Key comparison: mode of detection
- 55% of prostate cancers were found via an organized or opportunistic early-detection setting.
- Median age: 69.7 years
- Median PSA: 8.2 ng/mL
- PSA >20 ng/mL: 16.7%
- 45% were detected outside of early-detection settings (e.g., symptom-driven or incidental findings).
- Median age: 70.9 years
- Median PSA: 11.0 ng/mL
- PSA >20 ng/mL: 28.0%
Stage and grade at diagnosis
- Early-detected cases had more favorable stage distribution:
- UICC I: 68.3% vs 58.3% in non–early-detected
- UICC IV: 7.8% vs 16.4%
- High-grade disease (ISUP grade groups IV–V) was less frequent in early-detected cancers:
- 18.1% vs 24.2%
All reported differences were statistically significant.
Clinical takeaway
In this large real-world German cohort, prostate cancers detected in an early-detection context presented at a slightly younger age, with lower PSA values, earlier UICC stages, fewer ISUP grade group IV–V tumors, and a lower rate of primary metastatic disease than cancers detected outside of early-detection pathways. The authors interpret these data as supporting the utility of early detection for achieving more favorable initial disease profiles in prostate cancer.