Incidence, surveillance and natural history of high‐grade prostatic epithelial neoplasia in the era of multiparametric MRI and targeted biopsy

To our knowledge, this is the first study examining the incidence, natural history, and subsequent csPCa detection rates for iHGPIN in the era of mpMRI and MRI targeted biopsy. The lower prevalence of iHGPIN is attributed to the selection of biopsy candidates based on mpMRI and an increased likelihood of detecting pre-existing csPCa. Our findings provide compelling evidence that biopsy strategies limited to MRI targets will almost eliminate iHGPIN detection while decreasing detection of csPCa. A 3-year biopsy should be performed only in men with suspicious mpMRI.