Background/Objectives: Multiparametric MRI (mpMRI) is widely established as the standard imaging modality for detecting clinically significant prostate cancer (csPCa), yet it can be limited by cost, accessibility, and the need for specialized radiologist interpretation. Micro-ultrasound (micro-US) has recently emerged as a more accessible alternative imaging modality. This review evaluates whether the evidence base for micro-US meets thresholds comparable to those that led to MRI’s guideline adoption, synthesizes diagnostic performance data compared to mpMRI, and outlines future research priorities to define its clinical role. Methods: A targeted literature review of PubMed, Embase, and the Cochrane Library was conducted for studies published between 2014 and May 2025 evaluating micro-US in csPCa detection. Search terms included “micro-ultrasound,” “ExactVu,” “PRI-MUS,” and related terminology. Study relevance was assessed independently by the authors. Extracted data included csPCa detection rates, modality concordance, and diagnostic accuracy, and were synthesized and, rarely, restructured to facilitate study comparisons. Results: Micro-US consistently demonstrated non-inferiority to mpMRI for csPCa detection across retrospective studies, prospective cohorts, and meta-analyses. Several studies reported discordant csPCa lesions detected by only one modality, highlighting potential complementarity. The recently published OPTIMUM randomized controlled trial offers the strongest individual-trial evidence to date in support of micro-US non-inferiority. Conclusions: Micro-US shows potential as an alternative or adjunct to mpMRI for csPCa detection. However, additional robust multicenter studies are needed to achieve the evidentiary strength that led mpMRI to distinguish itself in clinical guidelines.

Objective: To characterize alcohol consumption and binge‐drinking patterns among individuals with GU cancers (prostate, kidney, bladder and testicular) compared to a propensity‐matched cohort without cancer in a large, nationally diverse population.Materials and Methods: We conducted a retrospective, cross‐sectional study utilizing data from the National Institutes of Health All of Us Research Program. Matching accounted for age, sex assigned at birth, smoking status, comorbidities and education/marital status. The primary outcome was self‐reported drinking frequency. The secondary outcomes were self‐reported binge‐drinking frequency and Alcohol Use Disorders Identification Test (AUDIT‐C) scores.Results: Drinking and binge‐drinking among individuals with GU malignancy (N = 11 522) closely resembled those of matched controls (N = 47 747), with the majority (53%) consuming at least 2–4 drinks per month. There was no significant association between GU cancer diagnosis and increased drinking frequency (OR: 0.99; p = 0.65), binge‐drinking frequency (OR: 0.85; p: 0.055) or AUDIT‐C (OR: 0.99; p =0.65). Individuals diagnosed with kidney cancer had reduced odds of higher alcohol use (OR: 0.76; p < 0.001) and AUDIT‐C score (OR: 0.83; p < 0.001) compared to controls.Conclusion: In this large cohort, including traditionally underrepresented minorities, alcohol use was highly prevalent among those with GU malignancies. Drinking behaviours were similar to individuals without cancer, underscoring the need for integration of lifestyle‐focused interventions into survivorship care, as alcohol remains a common and modifiable behaviour with wide‐ranging health implications.

Background Higher diet quality may be associated with a reduced risk of prostate cancer (PCa) grade reclassification (GR) on active surveillance (AS). However, there remain limited and conflicting data regarding whether physical activity may influence disease progression. Methods This is a prospective cohort study of men with Grade Group (GG) 1 PCa enrolled in AS. Patients completed detailed diet and physical activity surveys at time of AS enrollment. Physical activity was evaluated as metabolic equivalent of task (MET) hours per week, diet quality was measured as energy-adjusted Healthy Eating Index (E-HEI) score. Multivariable competing risk regressions were utilized to examine the association of diet and physical activity with GR on biopsy to ≥ GG2 or ≥ GG3. Results We included 828 men with a median follow up of 6.4 years. We found no significant association between MET hours per week and GR to ≥ GG2 (subdistribution hazard ratio (SHR) 1.04 per standard deviation (SD) increase in weekly MET hours, 95% confidence interval (CI) 0.90–1.21), or extreme GR to ≥ GG3 (SHR 1.03, 95% CI 0.79–1.35). Higher overall diet quality remained associated with significantly reduced risks of GR to ≥ GG2 (SHR 0.85 per SD increase in E-HEI score, 95% CI 0.73–0.99) and extreme GR (SHR 0.74, 95% CI 0.58–0.95). Conclusions In this prospective cohort study with longitudinal follow-up of men diagnosed with GG1 PCa pursuing AS, after adjusting for clinicopathological and lifestyle factors, increasing physical activity was not associated with a lower risk of PCa GR. A higher overall diet quality was associated with a reduced risk of GR for both GR outcomes. In our cohort, physical activity level does not appear to be associated with PCa progression on AS.