Figure 3.

PSA—based diagnostic workup for patients ≥ 65 years old, asymptomatic for glandular inflammation, including recommendations on second level approaches inferred from the available literature (references reported in parentheses). The above values represent pre-biopsy serum PSA concentrations. In black, information derived by this study. Note: Recommended active surveillance implies PSA retesting after two years and it is stopped if the risk of advanced cancer increases according to an absolute PSA increase over 1 µg/L. It is reasonable to endorse the PSA retesting interval recommended by the American Urological Association [2]. PCa, prostatic cancer; NPV, negative predictive value; ISUP, International Society of Urological Pathology; PPV, positive predictive value; 4Kscore, 4-kallikrein panel score; MRI, multiparametric magnetic resonance imaging; PD-RAS, Prostate Imaging-Reporting and Data System.