Presentation of Benefits and Harms in US Cancer Screening and Prevention Guidelines: Systematic Review

Caverly, Tanner J.; Hayward, Rodney A.; Reamer, Elyse; Zikmund‐Fisher, Brian J.; Connochie, Daniel; Heisler, Michele; Fagerlin, Angela

doi:10.1093/jnci/djv436

Cited by 75 publications

(44 citation statements)

References 31 publications

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“…The inclusion of harms associated with screening is another innovative characteristic of the new guidelines, especially in the Brazilian context, where this kind of outcome is rarely addressed in clinical guidelines. A recent systematic review found that 69% of guidelines that were identified for cancer prevention or early detection either failed to quantify the harms and benefits or presented them asymmetrically 21 . Thus, although the inclusion of harm outcomes is recommended by GRADE (Grading of Recommendations, Assessment, Development, and Evaluation), its implementation in guidelines for early detection of cancer is still incipient, even in the international context.…”

Section: Evolution Of Evidence On Early Detection Of Breast Cancer Anmentioning

confidence: 99%

Diretrizes para detecção precoce do câncer de mama no Brasil. I - Métodos de elaboração

et al. 2018

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Clinical guidelines are traditionally drafted by expert consensus. The benefits of mammographic screening have been questioned in recent years, owing to biases detected in the clinical trials that popularized its widespread use. Meanwhile, growing body of evidence on harms associated with mammographic screening also required a new approach, taking into account the uncertainties on the benefits and a balance between the gains and possible harms from screening. This article discusses the development of the new guidelines for early detection of breast cancer in Brazil, with details on the drafting methods and implications for the new recommendations. The new methodology features systematic literature reviews, assessment of the validity of the evidence, and the balance between each intervention's risks and benefits, ensuring greater transparency, reproducibility, and validity in the drafting process. The new guidelines also include recommendations for cases with suspicious signs and symptoms. The authors provide a detailed discussion of the advantages of the approach as compared to the traditional expert consensus model, as well as the methods' limitations and disadvantages. They also address the implications of various decisions, such as choices on study designs, screening effectiveness outcomes, definition of overdiagnosis, and methods for calculation.

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Section: Evolution Of Evidence On Early Detection Of Breast Cancer Anmentioning

confidence: 99%

Diretrizes para detecção precoce do câncer de mama no Brasil. I - Métodos de elaboração

et al. 2018

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“…The rationale of such a strategy lies on the limitations of PCa screening and diagnosis, which entails offering systematic transrectal ultrasound-guided biopsy (SB) to men presenting high levels of serum prostate-specific antigen (PSA) and/ or a suspicious digital rectal examination (DRE). First, many men without PCa manifest elevated PSA levels and undergo unnecessary biopsies, which often detect clinically insignificant cancers [4]. In addition, SB may miss up to 20% of cancers [5].…”

Section: Introductionmentioning

confidence: 99%

Negative Multiparametric Magnetic Resonance Imaging for Prostate Cancer: What's Next?

Panebianco

Barchetti

Simone³

et al. 2018

European Urology

158

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“…However, the positive predictive value of a raised PSA and subsequent TRUS guided biopsies is low [4], which leads to a considerable number of men undergoing unnecessary biopsies and a marked increase in the detection of clinically insignificant cancer [5]. This has significant cost implications and exposes patients to the inherent risk of biopsy and treatment [6].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of diffusion weighted imaging in the context of multi-parametric MRI of the prostate in the assessment of suspected low volume prostatic carcinoma

Papadopoulos

Phillips

Evans

et al. 2018

Magnetic Resonance Imaging

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Data from a multi-parametric MRI study of patients with possible early-stage prostate cancer was assessed with a view to creating an efficient clinical protocol. Based on a correlation analysis suggesting that diffusion-weighted imaging (DWI) scores are more strongly correlated with overall PIRADS scores than other modalities such as dynamic contrast enhanced imaging or spectroscopy, we investigate the combination of T2-weighted imaging (T2w) and DWI as a potential diagnostic tool for prostate cancer detection, staging and guided biopsies. Quantification of the noise floor in the DWI images and careful fitting of the data suggests that the mono-exponential model provides a very good fit to the data and there is no evidence of non-Gaussian diffusion for b-values up to 1000 s/mm 2 . This precludes the use of kurtosis or other non-Gaussian measures as a biomarker for prostate cancer in our case. However, the ADC scores for healthy and probably malignant regions are significantly lower for the latter in all 20 but one patient. The results suggest that a simplified mp-MRI protocol combining T2w and DWI may be a good compromise for a cost and time efficient, early-stage prostate cancer diagnostic programme, combining robust * Corresponding author.

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Presentation of Benefits and Harms in US Cancer Screening and Prevention Guidelines: Systematic Review

Cited by 75 publications

References 31 publications

Diretrizes para detecção precoce do câncer de mama no Brasil. I - Métodos de elaboração

Diretrizes para detecção precoce do câncer de mama no Brasil. I - Métodos de elaboração

Negative Multiparametric Magnetic Resonance Imaging for Prostate Cancer: What's Next?

Evaluation of diffusion weighted imaging in the context of multi-parametric MRI of the prostate in the assessment of suspected low volume prostatic carcinoma

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