A retrospective study of 618 asymptomatic Korean men who underwent biparametric MRI as part of a health check-up program compared this upfront-MRI approach with a simulated PSA-triggered pathway. The study reported that a PSA-triggered strategy would have avoided the large majority of MRI exams, biopsy consultations, and biopsies without missing clinically significant cancer in most scenarios, including in the PROSA trial-eligible subgroup where no cases were missed. The authors concluded that upfront MRI screening was inefficient in this population and that conventional PSA-gated screening remains supported, cautioning against extrapolating trial results across populations.
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