Four Years of Screening for Prostate Cancer with PSA and MRI

To the Editor: The randomized trial by Hugosson et al. (Sept. 26 issue) 1 evaluated the effect of magnetic resonance imaging (MRI)–targeted biopsy of MRI-positive lesions as compared with the standard approach of MRI-targeted biopsy plus systematic biopsy in patients with a prostate-specific antigen (PSA) level of 3 ng per milliliter or higher with respect to the detection of clinically insignificant prostate cancer (primary outcome) and clinically significant prostate cancer (secondary outcome). The authors found that detection of clinically insignificant and significant prostate cancers was reduced with MRI-targeted biopsy as compared with the standard approach, with a significant reduction in the . . .