Prostate cancer screening with prostate-specific antigen (PSA) test: a clinical practice guideline

Tikkinen, Kari A.O.; Dahm, Philipp; Lytvyn, Lyubov; Heen, Anja Fog; Vernooij, Robin W.M.; Siemieniuk, Reed; Wheeler, Russell; Vaughan, Bill; Fobuzi, Awah Cletus; Blanker, Marco H.; Junod, Noelle; Sommer, Johanna; Stirnemann, Jérôme; Yoshimura, Manabu; Auer, Reto; Macdonald, Helen; Guyatt, Gordon; Vandvik, Per Olav; Agoritsas, Thomas

doi:10.1136/bmj.k3581

Cited by 126 publications

(123 citation statements)

References 43 publications

Supporting

Mentioning

114

Contrasting

Unclassified

Order By: Relevance

“…However, cancer screening services differ in the available evidence of their impact on health outcomes. For example, colorectal cancer screening is recommended routinely as it has been shown to reduce mortality [5], breast cancer screening is often recommended, but the balance of benefits and harms is debated in Switzerland and worldwide [6,7], and routine screening of prostate cancer is discouraged by Swiss and European guidelines due to lacking evidence [8][9][10]. Potentially, differences in supporting evidence may lead to different utilization and regional variation patterns.…”

Section: Introductionmentioning

confidence: 99%

Variation of colorectal, breast and prostate cancer screening activity in Switzerland: Influence of insurance, policy and guidelines

et al. 2020

View full text Add to dashboard Cite

Variation in utilization of healthcare services is influenced by patient, provider and healthcare system characteristics. It could also be related to the evidence supporting their use, as reflected in the availability and strength of recommendations in clinical guidelines. In this study, we analyzed the geographic variation of colorectal, breast and prostate cancer screening utilization in Switzerland and the influence of available guidelines and different modifiers of access. Colonoscopy, mammography and prostate specific antigen (PSA) testing use in eligible population in 2014 was assessed with administrative claims data. We ran a multilevel multivariable logistic regression model and calculated Moran's I and regional level median odds ratio (MOR) statistics to explore residual geographic variation. In total, an estimated 8.1% of eligible persons received colonoscopy, 22.3% mammography and 31.3% PSA testing. Low deductibles, supplementary health insurance and enrollment in a managed care plan were associated with higher screening utilization. Cantonal breast cancer screening programs were also associated with higher utilization. Spatial clustering was observed in the raw regional utilization of all services, but only for prostate cancer screening in regional residuals of the multilevel model. MOR was highest for prostate cancer screening (1.24) and lowest for colorectal cancer screening (1.16). The reasons for the variation of the prostate cancer screening utilization, not recommended routinely without explicit shared decision-making, could be further investigated by adding provider characteristics and patient preference information. This first cross-comparison of different cancer screening patterns indicates that the strength of recommendations, mediated by specific health policies facilitating screening, may indeed contribute to variation.

show abstract

Section: Introductionmentioning

confidence: 99%

Variation of colorectal, breast and prostate cancer screening activity in Switzerland: Influence of insurance, policy and guidelines

et al. 2020

View full text Add to dashboard Cite

show abstract

“…A BMJ Rapid Recommendation in this issue1 reviews the evidence2 behind prostate cancer screening, including the latest large trial of prostate cancer screening with the prostate-specific antigen (PSA) test which showed no difference in prostate cancer mortality after 10 years 3. Neither the US Preventive Services Task Force4 nor Public Health England5 recommend population screening as there is little evidence that screening would reduce deaths from prostate cancer.…”

mentioning

confidence: 99%

What should doctors say to men asking for a PSA test?

Roland¹,

Neal²,

Buckley³

2018

BMJ

View full text Add to dashboard Cite

show abstract

“…With a rapidly aging population and changing lifestyles, the incidence of prostate cancer in China has increased from 4.0 per 100,000 to 20.0 per 100,000 between 1990 and 2017 [1]. The prostate-speci c antigen (PSA)-based screening program effectively detected early prostate cancer, and these patients can be cured using modern external beam radiotherapy (EBRT) or radical prostatectomy [2,3]. However, PSA screening is not performed in China, and patients have predominantly high-risk, locally advanced, or metastatic prostate cancer, and are more di cult to cure or incurable.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions) for prostate cancer confined to the pelvis: A single center retrospective analysis

Yao

Shou

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: There is an increasing application of moderately hypofractionated radiotherapy for prostate cancer. We presented our outcomes and treatment-related toxicities with moderately hypofractionated (67.5 Gy in 25 fractions) radiotherapy for a group of advanced prostate cancer patients from China.Methods: From November 2006 to December 2018, 246 consecutive patients with prostate cancer confined to the pelvis were treated with moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions). 97.6% of the patients received a different duration of androgen deprivation therapy. Failure-free survival (FFS), prostate cancer-specific survival (PCSS), overall survival (OS), and cumulative grade ≥2 late toxicity were evaluated using the Kaplan-Meier actuarial method. Prognostic factors for FFS, PCSS, and OS were analyzed.Results: The median follow-up time was 74 months (range: 6-150 months). For all patients, the 5- and 10-year FFS rates were 80.0% (95%CI: 74.7%-85.7%) and 63.5% (95%CI: 55.4%-72.8%). The failure rates for the intermediate, high-risk, locally advanced, and N1 groups were 6.1%, 13.0%, 18.4%, and 35.7%, respectively (P = 0.003). Overall, 5- and 10-year PCSS rates were 95.7% (95%CI: 93.0%-98.5%) and 88.2% (95%CI: 82.8%-93.8%). Prostate cancer-specific mortality rates for the high-risk, locally advanced, and N1 groups were 4.0%, 8.2%, and 23.8%, respectively (P＜0.001). Overall, 5- and 10-year actuarial OS rates were 92.4% (95%CI: 88.8%-96.1%) and 72.7% (95%CI: 64.8%-81.5%). High level prostate-specific antigen and positive N stage were significantly associated with worse FFS (P＜0.05). Advanced T stage and positive N stage emerged as worse predictors of PCSS (P＜0.05). Advanced age, T stage, and positive N stage were the only factors that were significantly associated with worse OS (P＜0.05). The 5-year cumulative incidence rate of grade ≥ 2 late GU and GI toxicity was 17.8% (95%CI: 12.5%-22.7%) and 23.4% (95%CI: 17.7%-28.7%), respectively. Conclusions: Moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions) for this predominantly high-risk, locally advanced, or N1 in Chinese patients demonstrates encouraging long-term outcomes and acceptable toxicity. This fractionation schedule deserves further evaluation in similar populations.

show abstract

Prostate cancer screening with prostate-specific antigen (PSA) test: a clinical practice guideline

Cited by 126 publications

References 43 publications

Variation of colorectal, breast and prostate cancer screening activity in Switzerland: Influence of insurance, policy and guidelines

Variation of colorectal, breast and prostate cancer screening activity in Switzerland: Influence of insurance, policy and guidelines

What should doctors say to men asking for a PSA test?

Long-term outcomes of moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions) for prostate cancer confined to the pelvis: A single center retrospective analysis

Contact Info

Product

Resources

About