Prostate cancer screening illustration balancing risks and benefits of over treatment.

Prostate Cancer Screening: Are We Overtreating Low-Risk Cases?

Nico Varela in Health & Wellness December 2025 • 4 min read.

"Rethinking the need for extensive staging in all prostate cancer patients: A Chilean study highlights the potential for a more tailored approach."

Prostate cancer is a significant health concern for men worldwide. Early detection and accurate staging are crucial for determining the most appropriate treatment plan. Staging, in particular, helps doctors determine if the cancer has spread beyond the prostate gland, influencing treatment decisions such as surgery, radiation therapy, or hormone therapy.

However, the role of extensive staging procedures, which often include imaging tests like bone scans and CT scans, has become a topic of debate, especially in patients diagnosed with low-risk prostate cancer. These procedures can be costly, expose patients to radiation, and may not always be necessary.

A recent study published in the journal Revista Médica de Chile sheds light on this issue. Researchers from a national clinic in Chile investigated the usefulness of imaging studies in a cohort of 241 prostate cancer patients. Their findings suggest that a more selective approach to staging, based on individual risk factors, could be beneficial.

Why a One-Size-Fits-All Approach to Prostate Cancer Staging May Not Be Ideal

Prostate cancer screening illustration balancing risks and benefits of over treatment.

The Chilean study retrospectively reviewed the medical records of 241 patients diagnosed with prostate cancer between 2003 and 2013. The patients were then categorized into risk groups (low, intermediate, and high) based on the D'Amico classification, a widely used system that considers factors like PSA levels, Gleason score (a measure of cancer aggressiveness), and clinical stage.

The researchers analyzed the frequency of imaging studies ordered for each risk group and their effectiveness in detecting metastases (cancer spread). Here's what they found:

A significant portion of patients, 64%, underwent at least one imaging study.
The rate of imaging studies varied by risk group: 49% of low-risk, 78% of intermediate-risk, and 87% of high-risk patients.
Notably, no metastases were detected in the low-risk group who underwent imaging.
Metastases were found in 7% of the intermediate-risk group and a substantial 62% of the high-risk group.

These findings highlight a crucial point: the likelihood of detecting metastases varies significantly depending on the patient's risk profile. The study suggests that routine staging in low-risk prostate cancer patients may not be warranted, potentially exposing them to unnecessary costs and radiation without providing significant clinical benefit.

A Call for Personalized Prostate Cancer Care

The Chilean study adds to the growing body of evidence suggesting that a more personalized approach to prostate cancer management is needed. While staging is undoubtedly important for high-risk patients, routinely subjecting low-risk individuals to extensive imaging may not be justified. By carefully considering individual risk factors, clinicians can make more informed decisions about staging, potentially reducing costs, minimizing radiation exposure, and improving the overall quality of care for men with prostate cancer.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.4067/s0034-98872017000500004, Alternate LINK

Title: ¿Es Necesario Realizar Un Estudio De Etapificación En Todos Los Pacientes Con Cáncer De Próstata?: Experiencia De Un Centro Clínico Nacional

Subject: General Medicine

Journal: Revista médica de Chile

Publisher: SciELO Agencia Nacional de Investigacion y Desarrollo (ANID)

Authors: Nagel Martínez M, Carlos Calvo, Álvaro Ibarra, Christian Ramos, Norman Zambrano

Published: 2017-05-01

Everything You Need To Know

What is the significance of prostate cancer staging?

Prostate cancer staging is crucial for determining the extent of the cancer's spread beyond the prostate gland. This information directly influences treatment decisions, such as the choice between surgery, radiation therapy, or hormone therapy. Accurate staging helps doctors tailor the most appropriate and effective treatment plan for each individual patient, improving outcomes and quality of life.

What did the Chilean study investigate regarding prostate cancer staging?

The study from Chile investigated the necessity of extensive staging procedures, including imaging tests, for all prostate cancer patients. They aimed to determine if a risk-based approach to staging could reduce unnecessary costs and radiation exposure. The research focused on analyzing the usefulness of imaging studies in different risk groups (low, intermediate, and high) based on the D'Amico classification, considering factors like PSA levels, Gleason score, and clinical stage.

How does the D'Amico classification play a role in prostate cancer risk assessment?

The D'Amico classification is a widely used system that categorizes prostate cancer patients into risk groups (low, intermediate, and high). This classification considers several factors: PSA levels, which indicate the amount of prostate-specific antigen in the blood; the Gleason score, which assesses the aggressiveness of the cancer based on the appearance of the cells; and the clinical stage, which reflects the extent of the tumor within the prostate. By evaluating these factors, the D'Amico classification helps clinicians assess the likelihood of cancer spread (metastases) and guides decisions about the need for extensive staging.

Why might extensive staging not be ideal for all prostate cancer patients, especially those in the low-risk category?

Extensive staging, often involving imaging tests like bone scans and CT scans, can expose patients to radiation and incur significant costs. The Chilean study found that imaging studies didn't detect metastases in the low-risk group. This suggests that routine staging in these patients might not be clinically beneficial. Therefore, a more personalized approach, focusing staging efforts on patients with intermediate or high-risk profiles based on D'Amico classification, can potentially reduce unnecessary costs and radiation exposure, improving the overall quality of care.

In what ways does the Chilean study support a shift towards personalized prostate cancer care?

The Chilean study provides evidence for a more personalized approach by highlighting that the likelihood of detecting cancer spread (metastases) varies significantly depending on the patient's risk profile as determined by the D'Amico classification. The study's findings suggest that routine staging for low-risk patients may be unwarranted. By carefully considering individual risk factors, clinicians can make more informed decisions about staging. This personalized approach aims to reduce unnecessary costs, minimize radiation exposure, and ultimately enhance the quality of care for men diagnosed with prostate cancer, tailoring diagnostic and treatment strategies to the specific needs of each patient.