Canadian Urological Association recommendations on prostate cancer screening and early diagnosis

Rendon, Ricardo; Mason, Ross; Marzouk, Karim; Finelli, Antonio; Saad, Fred; So, Alan; Violette, Philippe D.; Breau, Rodney H.

doi:10.5489/cuaj.4888

Cited by 60 publications

(61 citation statements)

References 102 publications

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“…We observed mostly preexisting favorable trends, concordant with co-occurring guidelines aimed at maximizing detection of aggressive and potentially lethal disease while minimizing harms associated with unnecessary prostate biopsy and with the detection of clinically insignificant prostate cancer. 25 The funding reform may have encouraged even more desirable patient selection for RP. However, assessment of potential positive and negative consequences of these policy changes is highly challenging in the presence of dominant underlying preexisting trends.…”

Section: Discussionmentioning

confidence: 99%

Management Strategies and Patient Selection After a Hospital Funding Reform for Prostate Cancer Surgery in Canada

et al. 2019

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Key Points Question Was a change in hospital funding policy for radical prostatectomy associated with changes in management of localized prostate cancer in the province of Ontario, Canada? Findings In this population-based interrupted time series study, which included 33 128 patients with incident localized prostate cancer and 17 159 patients treated with radical prostatectomy, no statistically significant association of the change in hospital funding policy with most outcomes was found. However, potential improvement in appropriate patient selection for prostate cancer surgery was observed. Meaning The implementation of a hospital funding policy change aimed at improving health care quality and value was not associated with management of localized prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Management Strategies and Patient Selection After a Hospital Funding Reform for Prostate Cancer Surgery in Canada

et al. 2019

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“…Two recent Canadian Urological Association (CUA) publications outline recommendations on surgical Screening and detection 1. The CUA endorses prostate cancer screening and detection in appropriately selected men 14 . However, the public health benefit from these recommendations is derived from long-term implementation and has no role in an acute setting.…”

Section: Introductionmentioning

confidence: 99%

A Canadian framework for managing prostate cancer during the COVID-19 pandemic: Recommendations from the Canadian Urologic Oncology Group and the Canadian Urological Association

Kokorovic

Hotte

et al. 2020

CUAJ

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triaging and the use of systemic therapies in genitourinary malignancies 7,9 . The purpose of this publication is to provide a multidisciplinary framework focused on prostate cancer management in the setting of the COVID-19 global pandemic within the Canadian context. General principles1. This consensus statement is a guide to help physicians manage prostate cancer during the acute phase of a pandemic. Treatment prioritization must take into account regional differences in infection rates, resource capacity and mitigation efforts. The current pandemic has had a widespread reach across all Canadian communities, but we recognize that the degree of impact varies, and that provincial and institutional policies are not uniform. Physicians must continue to monitor a continuously evolving situation and make adjustments to clinical decisions as deemed appropriate. The risk of serious morbidity resulting from SARS-CoV-2 infection may outweigh thecompeting risk of prostate cancer in many men. Observation of prostate cancer in carefully selected patients does not increase long-term mortality 10,11 , and therefore shortterm treatment delays are unlikely to lead to disease progression and worse outcomes . All management decisions should be based on this core principle. Appropriate patient counseling and shared decision making is strongly encouraged.Men diagnosed with prostate cancer have increased anxiety and psychological distress 12,13 . This will undeniably become amplified in the setting of a global health crisis. Despite resource restrictions and changes in treatment recommendations, physicians must continue to address the needs of patients and involve them in the decision-making process. This approach may decrease patient anxiety levels and improve outcomes once regular practice resumes. Prioritization must be given to limiting exposures of patients and healthcare workers toSARS-CoV-2. Implementation of telehealth visits significantly reduces the risk of infection among frontline personnel and patients, but also preserves critically needed hospital resources. For these reasons, telehealth visits are strongly encouraged. In-person consultations should be limited to men with new symptoms, those requiring a physical examination and for the evaluation and management of treatment-related serious adverse events. In men who require an in-person assessment, consideration should be given to not repeating visits when two specialists are consulted, nor when pre-operative assessment is needed. The healthcare provider should coordinate their needs to minimize patient's visits. CUAJ -Consensus Statement Kokorovic et al Managing prostate cancer during COVID-193

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“…The Canadian Task Force on Preventive Health Care does not recommend screening for prostate cancer with the PSA blood test or the DRE in men without a previous diagnosis of prostate cancer [8]. However, the Canadian Urological Association has recommended that family practitioners start offering PSA testing at 50 years of age for most men and at 45 years of age for men with a high risk of prostate cancer [9]. Men electing for PSA screening are often offered a DRE for additive information beyond the PSA [9].…”

Section: Introductionmentioning

confidence: 99%

“…However, the Canadian Urological Association has recommended that family practitioners start offering PSA testing at 50 years of age for most men and at 45 years of age for men with a high risk of prostate cancer [9]. Men electing for PSA screening are often offered a DRE for additive information beyond the PSA [9]. In the event that a patient has an elevated PSA and/or abnormal DRE findings, the patient should be referred to a urologist.…”

Section: Introductionmentioning

confidence: 99%

Anatomical 3D-Printed Silicone Prostate Gland Models and Rectal Examination Task Trainer for the Training of Medical Residents and Undergraduate Medical Students

Strong¹,

O'Regan²,

Goudie³

et al. 2020

Cureus

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The current generation of graduating medical students is entering into practice with minimal exposure to the digital rectal examination (DRE), a necessary component of a complete physical examination. Simulation-based medical education (SBME) using anatomical silicone models and task trainers can provide hands-on training opportunities for medical students to rehearse DREs. However, there is a scarcity of affordable, validated, and anatomically correct silicone prostate models and task trainers for rehearsing DREs. This technical report describes and validates evidence for silicone prostate models and a DRE task trainer created from threedimensional (3D)-printed molds for medical student-and resident-training and clinical skills maintenance.

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Canadian Urological Association recommendations on prostate cancer screening and early diagnosis

Cited by 60 publications

References 102 publications

Management Strategies and Patient Selection After a Hospital Funding Reform for Prostate Cancer Surgery in Canada

Management Strategies and Patient Selection After a Hospital Funding Reform for Prostate Cancer Surgery in Canada

A Canadian framework for managing prostate cancer during the COVID-19 pandemic: Recommendations from the Canadian Urologic Oncology Group and the Canadian Urological Association

Anatomical 3D-Printed Silicone Prostate Gland Models and Rectal Examination Task Trainer for the Training of Medical Residents and Undergraduate Medical Students

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