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Prostate cancer (PCa) is a major public health concern for men globally and the most commonly diagnosed cancer among men in the European Union (EU). Despite large trials suggesting benefits from early detection of PCa, risks of overdiagnosis and overtreatment are evident. In 2022, the EU Commission proposed introducing prostate-specific antigen (PSA) testing for men in an organised setting, in combination with magnetic resonance imaging (MRI) scanning as a follow-up test to minimise these risks. PRostate cancer Awareness and Initiative for Screening Europe (PRAISE-U) is a pilot study evaluating the implementation of a risk-stratified population-based approach to PCa screening in Ireland, Lithuania, Poland, and two areas in Spain (Galicia and Manresa) for feasibility, efficacy, and cost effectiveness. As per the protocol designed for the pilots, men aged 50–69 yr residing within the catchment area of the study sites will be invited to participate. Those consenting to participate will undergo PSA testing, and men with PSA >3 ng/ml will undergo risk stratification before MRI and, if necessary, after MRI before undergoing biopsy. A collaborative user board comprising health care professionals, patients, and decision-makers will be formed to provide stakeholder input throughout the study. PRAISE-U will be evaluated on three major pillars: analysis of clinical and programme outcomes, psychosocial impact, and cost effectiveness. A set of key performance indicators (KPIs) has been developed to be piloted in the PRAISE-U pilot sites. The KPIs will serve to assess the performance and outcomes of risk-stratified PCa screening at each site. A REDCap database will be used to collect and manage pseudoanonymised data from the pilot sites. Ethics approval was obtained from each pilot site. The PRAISE-U pilot implementation is expected to commence in the 3rd quarter of 2024 for 12 mo and provide valuable data on the implementation outcomes of a risk-stratified screening approach across Europe. The findings is expected to inform the development of an optimised screening strategy with an acceptable benefit to harm ratio.

Abstract Introduction The Irish Prostate Cancer Outcomes Research (IPCOR) Study collected longitudinal data on men newly diagnosed with Prostate Cancer (PC). Understanding the nuances of disease presentation is essential, considering the high incidence of PC in Ireland. This study aims to characterise disease presentation features, identify factors related to socio demographic disparities in presentation following opportunistic screening, and shed light on potential inequality challenges within Ireland’s healthcare structure. Methods Data were collected on demographics, diagnosis, and treatment of 6,816 men newly diagnosed with PC across 16 hospitals in the Republic of Ireland from February 2016 to January 2020. A complete case analysis was carried out, complemented by a sensitivity analysis for addressing sites with high rates of missing values. Multivariable logistic regression was conducted to examine the association between various predictor variables and the initial presentation to the urology clinic subsequent to opportunistic screening. Results A multivariable logistic regression model revealed that the type of hospital was a key determinant in post-opportunistic screening presentation, with patients in public hospitals 45.7% more likely to be presented following screening compared to those in private hospitals. Urban residents were 34% more likely to present following screening than rural ones. Age negatively influenced presentation following screening likelihood, decreasing by 3.4% yearly. Discussion Our research has highlighted the key features of PC presentation in Ireland, revealing potential inequalities affecting mainly urban populations, middle socioeconomic groups, and individuals with inadequate healthcare coverage. While the differences we observed in various groups may appear subtle and may indicate the success of the Rapid Access Prostate Clinics, they are still significant in pinpointing specific populations that require special attention. Conclusions By addressing these nuanced differences in access to healthcare, socioeconomic status, and urban versus rural residence and implementing tailored strategies, we can work towards closing disparity gaps in PC, ultimately leading to improved health outcomes and equity across all population segments.

Purpose To describe the Irish Prostate Cancer Outcomes Research (IPCOR) registry. The cohort was collected to inform and improve the prostate cancer journey of men in Ireland.Participants Established in 2015, IPCOR was a unique large-scale prospective cohort study registering men with prostate cancer in Ireland. From 2016 to 2020, IPCOR collected data on 6816 men who were newly diagnosed with prostate cancer across 16 hospitals, both public and private. A comprehensive clinical dataset was collected, capturing detailed information on men’s diagnosis, treatments and follow-up. In addition, a subset of 873 men completed patient-reported outcome measures.Findings to date The IPCOR study has revealed several key insights into prostate cancer diagnosis and treatment in Ireland. The data indicate a high rate of diagnosis through opportunistic Prostate-Specific Antigen screening, with many cases identified at an early stage.Future plans IPCOR invites collaboration from the global cancer research community to use this resource to advance prostate cancer research and improve patient outcomes worldwide. IPCOR aims to continue updating long-term survival follow-up data for this cohort. It also plans to continue its collaborative approach with patients, engaging with the Lived Experience Advisory Panel in interpreting results emerging from this dataset. Moving forward, IPCOR is planning its next phase of the project, IPCOR 2.0. This will be a prospective, longitudinal, multi-centre clinical quality registry and biorepository.