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ORIGINAL RESEARCH article

Front. Oncol.

Sec. Cancer Imaging and Image-directed Interventions

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1636292

This article is part of the Research TopicApproaches and Advances in Urologic Cancer EpidemiologyView all articles

Prostate cancer diagnostics: evolution over 30 years and the impact of education level – a prospective population-based study

Provisionally accepted
  • 1Department of Imaging and Functional medicine, Skåne University Hospital, Lund, Sweden
  • 2Department of Translational Medicine, Lund University, Diagnostic radiology, Malmö, Sweden
  • 3Helsingborgs lasarett, Helsingborg, Sweden
  • 4Diagnostic Radiology, Department of Clinical Sciences, Lund University, Lund, Sweden
  • 5Department of Translational Medicine, Lund University, Malmö, Sweden
  • 6Department of Urology, Skåne University Hospital, Malmö, Sweden

The final, formatted version of the article will be published soon.

Objective: The aim of this study is to describe how the use of diagnostic imaging for prostate cancer (PCa) has evolved over time and to determine whether there are any di\erences in access to diagnostic imaging, type of cancers detected, and mortality based on the education level of patients. Methods: 11,063 men were recruited between 1991 and 1996 and then prospectively followed until 2020. All new cases of PCa were recorded. At baseline, data on education level, heredity for cancer, and health status were collected. Incident PCa diagnoses during the study period were ascertained through record matching with national healthcare registers. The registers provided more detailed data on the cancer type and imaging performed. Results: 1,816 men with diagnosed were PCa during the study period were included. No di\erences were seen between education levels in regard to access to diagnostic methods or tumour aggressiveness at diagnosis. Furthermore, no di\erences were seen in PCa-specific mortality, but there was higher overall mortality among individuals with a lower education level. During the study period, the use of plain radiographic examinations decreased, while the use of computed tomography (CT), prostate magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) increased. Conclusion: Early detection and diagnostic methods for PCa have evolved over the last 30 years. In a healthcare system where men diagnosed with PCa had equal access to diagnostic pathways, no di\erences are seen in PCa specific mortality. Nevertheless, men with lower education level still had higher overall mortality.

Keywords: prostate cancer screening, Diagnostic Radiology, Epidemiology, prostate cancer, Mortality

Received: 27 May 2025; Accepted: 15 Sep 2025.

Copyright: © 2025 Will, Thimansson, Bengtsson, Bjartell, Zackrisson and Baubeta Fridh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Erik Baubeta Fridh, erik.baubeta_fridh@med.lu.se

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