A mobile health application for prostate cancer antigen dosage: is it time to say goodbye to classic screening methods?

OBJECTIVE: To evaluate the quality of apps for prostate cancer antigen (PSA) dosage, available for downloading on the iOS and Android platforms, discussing the potential role of mobile health applications (MHAs) in update the screening protocol. METHODS: An observational cross-sectional descriptive study of all smartphone apps for PSA dosage was performed through the most used platforms (iOS and Android). On 10 February 2023, a total of 457 apps were found according to the search criteria. Mobile Application Rating Scale (MARS) was adopted to assess apps' quality. Then, MARS items were analyzed through descriptive statistics and bivariate correlations between study variables with Pearson's coefficient. RESULTS: Of all samples, 24 MHAs were included in the final analysis: 12% (n = 3) from the iTunes App Store and 88% (n = 21) from the Google Play Store. According to the MARS quality assessment, the mean values 2.61, 2.94, 3.11, 2.97, 2.94, and 2.63 were measured for the engagement, functionality, aesthetics, information, overall mean score, and subjective quality, respectively. CONCLUSION: The MHAs for PSA were under the acceptability threshold and future improvements are required. Moreover, MHAs appropriately developed could play an active role in PSA screening campaign and adherence of follow-up regimens. Finally, the virtual instrument could both reduce the social divide of access to care for patients in rural areas and improve PCA detection, speeding up the active treatment.

The Role of miRNA in Testicular Cancer: Current Insights and Future Perspectives.

Background and Objectives: Despite advancements in the diagnosis and treatment of testicular germ cell tumours (TGTCs), challenges persist in identifying reliable biomarkers for early detection and precise disease management. This narrative review addresses the role of microRNAs (miRNAs) as potential diagnostic tools and therapeutic targets in the treatment of TGCTs. Materials and Methods: Three databases (PubMed®, Web of Science™, and Scopus®) were queried for studies investigating the utility of miRNA as diagnostic tools, assessing their prognostic significance, and evaluating their potential to guide TGCT treatment. Different combinations of the following keywords were used, according to a free-text protocol: "miRNA", "non-coding RNA", "small RNA", "Testicular Cancer", "seminomatous testicular germ cell", "non-seminomatous testicular germ cell". Results: The potential of miRNAs as possible biomarkers for a non-invasive diagnosis of TGCT is appealing. Their integration into the diagnostic pathway for TGCT patients holds the potential to enhance the discriminative power of conventional serum tumour markers (STMs) and could expedite early diagnosis, given that miRNA overexpression was observed in 50% of GCNIS cases. Among miRNAs, miR-371a-3p stands out with the most promising evidence, suggesting its relevance in the primary diagnosis of TGCT, particularly when conventional STMs offer limited value. Indeed, it demonstrated high specificity (90-99%) and sensitivity (84-89%), with good positive predictive value (97.2%) and negative predictive value (82.7%). Furthermore, a direct relationship between miRNA concentration, disease burden, and treatment response exists, regardless of disease stages. The initial evidence of miRNA decrease in response to surgical treatment and systemic chemotherapy has been further supported by more recent results suggesting the potential utility of this tool not only in evaluating treatment response but also in monitoring residual disease and predicting disease relapse. Conclusions: MiRNAs could represent a reliable tool for accurate diagnosis and disease monitoring in the treatment of TGCT, providing more precise tools for early detection and treatment stratification. Nevertheless, well-designed clinical trials and comprehensive long-term data are needed to ensure their translation into effective clinical tools.