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Prostate cancer (PCa) is a significant healthcare problem in many western countries [1]. The current gold standard for diagnosis of PCa involves a highly invasive systematic transrectal or transperineal tissue biopsy. A growing part of the clinical community now recognises the interest of early diagnosis of clinically relevant cancers (ISUP grade 2, Gleason patterns (GP) 4 and higher) against ISUP1 tissue. ISUP1, consisting of only GP3, has a relatively indolent course, with cancer-specific deaths or metastases occurring in less than 1% of men [2]. Despite optimized utilization of mpMRI, the incidence of negative or clinically non-significant PCa following prostate biopsy remains very high (47% in our cohort). Earlier cancer grading and more accurate, targeted biopsies could help avoid unnecessary suffering, morbidity, and over-treatment for men with an ISUP1 diagnosis.
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