<p><strong>When the risk of clinically significant prostate cancer is sufficiently low based on available clinical, laboratory, and imaging data, clinicians and patients may forgo near-term prostate biopsy. (<em>Clinical Principle</em>)</strong></p>
Discussion
Discussion
<p>When assessing a patient’s risk for prostate cancer, validated online calculators/nomograms may be used to incorporate multiple risk factors (e.g., PSA, family history of prostate cancer, race/ethnicity, age, DRE, percent free PSA, PSA density) to estimate risk of prostate cancer and risk of clinically significant prostate cancer.<sup>107, 108</sup> In many cases, the estimated risk for significant prostate cancer would be considered low as perceived by both the clinician and patient. Therefore, it would be reasonable to forgo a prostate biopsy in such instances following SDM, even where there may be some clinical features that indicate a risk for prostate cancer existing (e.g., mildly elevated PSA). If a decision is made after SDM to forgo a biopsy or additional testing, patients should be informed of their risk for underdiagnosing clinically significant prostate cancer and the need for future follow up screening, as appropriate.</p>