Prostate cancer is the third cause of death in developed countries, suggesting a role for systematic screening. However, no country has considered this policy yet. On the contrary, an individual early diagnostic process based on a risk adapted strategy is now considered. In an informed patient with at least fifteen years of life expectancy, the process starts at 45 years of age in a man at risk. Otherwise, it starts at 50 years of age. While already based on a prostate-specific antigen test and a digital rectal examination, the MRI as well as risk calculators or biological tests might be helpful to avoid unnecessary biopsy. However, it must be remembered that finding a tumour does not mean a systematic treatment.

(BELG J MED ONCOL 2019;13(3):93–97)