PSA-Screening und molekulare Marker

Lakes, Jale; Arsov, Christian

doi:10.1007/s00120-019-0900-y

Cited by 14 publications

(10 citation statements)

References 21 publications

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“…This may be due, in part, to the results of a systematic review, concluding that at best, PCa screening leads to a small reduction in disease-specific mortality over 10 years but has no effect on overall mortality (9). As large clinical trials have shown inconsistent results with respect to whether PSA testing leads to a reduction in PCa mortality, and because guidelines handle different recommendations, the observed disagreement among physicians is understandable (2)(3)(4)(5)(6)(7)(8). A survey among 305 primary care physicians in Sweden found the majority of physicians reported a less positive attitude toward PSA testing compared with the physicians in our survey (25).…”

Section: Discussionmentioning

confidence: 99%

“…However, PCa screening by PSA testing is still debated. Large-scale screening studies have shown inconsistent results for PSA with respect to a decrease in PCa mortality (2)(3)(4)(5)(6)(7)(8). A systematic review concluded that at best, PCa screening leads to a small reduction in diseasespecific mortality over 10 years but has no effect on overall mortality (9).…”

Section: Introductionmentioning

confidence: 99%

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Attitudes Toward and Use of Prostate-Specific Antigen Testing Among Urologists and General Practitioners in Germany: A Survey

et al. 2021

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BackgroundIn 2020, around 1.4 million new prostate cancer (PCa) cases were recorded worldwide. Early detection of PCa by prostate-specific antigen (PSA) screening remains debated, leading to different specialist-specific recommendations in PCa guidelines. This study aimed to assess attitudes toward and use of PSA testing among urologists in Germany and general practitioners (GPs) in Lower Saxony (Germany).MethodsA nationwide questionnaire was sent to urologists via the mailing lists of the Professional Association of German Urologists and the German Urological Society. A version of the questionnaire for GPs was sent to email addresses via the Association of Statutory Health Insurance Physicians Lower Saxony. The online questionnaires covered use of PSA testing, information communication, handling of test results, and handling of/knowledge about national and international guidelines and recommendations on early detection of PCa. Statistical analysis was performed at a descriptive level.ResultsIn total, 432 of 6,568 urologists (6.6%) and 96 of 1,579 GPs (6.1%) participated in this survey. Urologists and GPs differed in their attitudes and approaches toward PSA testing. Most urologists (86.8%, n=375) judged the test as “very meaningful” or “meaningful”, compared with 52.1% (n=50) of GPs. Almost two-thirds of the urologists (64.4%, n=278) viewed the PCa mortality reduction by PSA testing as proven, compared with one-fifth of GPs (20.8%, n=20). Almost 80% of male urologists (79.9%, n=291) indicated that they would undergo a PSA test in the future (again), compared with 55.1% of male GPs (n=38). In addition, 56.3% (n=243) of urologists stated that “considerably more than half” or “almost all” men aged 45 years or older received a PSA test, compared with 19.8% (n=19) of GPs.ConclusionsUrologists are more convinced about the PSA test than GPs. PSA testing is therefore used more often in urological settings, although the preselected patient population must be considered. In accordance with specialist-specific recommendations, GPs show a more reserved approach toward PSA testing. Instead of focusing on different attitudes and recommendations on PSA testing, the exchange between specialist groups should be improved to achieve a consistent approach to PSA testing.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Attitudes Toward and Use of Prostate-Specific Antigen Testing Among Urologists and General Practitioners in Germany: A Survey

et al. 2021

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“… 16 17 The same applies, for example, to PSA screening for prostate cancer, where only a minority of those who are ultimately identified via the screening as prostate cancer cases and treated would have had their lives shortened by prostate cancer. 18 In other words, even true positives can lead to overtreatment. This also goes for AD identified presymptomatically: most people with preclinical AD will die without having clinical symptoms of AD.…”

Section: Different Kinds Of Screening: Ethical Aspectsmentioning

confidence: 99%

Novel drug candidates targeting Alzheimer’s disease: ethical challenges with identifying the relevant patient population

et al. 2021

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Intensive research is carried out to develop a disease-modifying drug for Alzheimer’s disease (AD). The development of drug candidates that reduce Aß or tau in the brain seems particularly promising. However, these drugs target people at risk for AD, who must be identified before they have any, or only moderate, symptoms associated with the disease. There are different strategies that may be used to identify these individuals (eg, population screening, cascade screening, etc). Each of these strategies raises different ethical challenges. In this paper, we analyse these challenges in relation to the risk stratification for AD necessary for using these drugs. We conclude that the new drugs must generate large health benefits for people at risk of developing AD to justify the ethical costs associated with current risk stratification methods, benefits much larger than current drug candidates have. This conclusion raises a new set of ethical questions that should be further discussed.

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“…At the same time, PSA-based screening in men aged ≥70 years was not recommended (19). In the Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP) study in Great Britain, 419,582 men were randomized to a single PSA screening intervention versus standard practice of no screening, and the groups showed no significant difference in PCa mortality after a median follow-up of 10 years, although the detection of low-risk PCa cases was higher in the PSA screening group (20,21). A recent systematic review concluded that, at best, PCa screening leads to a small reduction in disease-specific mortality over 10 years but has no effect on overall mortality (22).…”

Section: Introductionmentioning

confidence: 99%

Differences in Prostate Cancer Incidence and Mortality in Lower Saxony (Germany) and Groningen Province (Netherlands): Potential Impact of Prostate-Specific Antigen Testing

Kappen

Bock

Sirri³

et al. 2021

Front. Oncol.

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BackgroundProstate cancer (PCa) is the most frequent cancer among men in Europe. Differences in PCa incidence around the world can be partly explained by variations in recommendations for prostate-specific antigen (PSA), particularly for early detection. For example, the PSA testing policy is more conservative in the Netherlands than in Germany. To better understand the relationship between PSA testing recommendations and PCa incidence, stage distribution, and mortality, we compared these variables over time between Lower Saxony in northwestern Germany and the neighboring province of Groningen in the Netherlands.MethodsPopulation data, tumor stage- and age group-specific PCa incidence (ICD-10 C61) and mortality rates for Lower Saxony and Groningen were obtained from the Lower Saxony Epidemiological Cancer Registry, the Netherlands Comprehensive Cancer Organization, and Statistics Netherlands for 2003–2012. Incidence and mortality rates per 100,000 person-years were age-standardized (ASR, old European standard). Trends in age-standardized incidence rates (ASIR) and mortality rates (ASMR) for specific age groups were assessed using joinpoint regression.ResultsThe mean annual PCa ASIR between 2003 and 2012 was on average 19.9% higher in Lower Saxony than in Groningen (120.5 vs. 100.5 per 100,000), while the mean annual ASMR was on average 24.3% lower in Lower Saxony than in Groningen (21.5 vs. 28.4 per 100,000). Between 2003 and 2012, the average annual percentage change (AAPC) in PCa incidence rates did not change significantly in either Lower Saxony (−1.8%, 95% CI −3.5, 0.0) or Groningen (0.2%, 95% CI −5.0, 5.7). In contrast, the AAPC in mortality rate decreased significantly during the same time period in Lower Saxony (−2.5%, 95% CI −3.0, −2.0) but not in Groningen (0.1%, 95% CI −2.4, 2.6).ConclusionsHigher PCa incidence and lower PCa-related mortality was detected in Lower Saxony than in Groningen. Although recommendations on PSA testing may play a role, the assessed data could not offer obvious explanations to the observed differences. Therefore, further investigations including data on the actual use of PSA testing, other influences (e.g., dietary and ethnic factors), and better data quality are needed to explain differences between the regions.

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PSA-Screening und molekulare Marker

Cited by 14 publications

References 21 publications

Attitudes Toward and Use of Prostate-Specific Antigen Testing Among Urologists and General Practitioners in Germany: A Survey

Attitudes Toward and Use of Prostate-Specific Antigen Testing Among Urologists and General Practitioners in Germany: A Survey

Novel drug candidates targeting Alzheimer’s disease: ethical challenges with identifying the relevant patient population

Differences in Prostate Cancer Incidence and Mortality in Lower Saxony (Germany) and Groningen Province (Netherlands): Potential Impact of Prostate-Specific Antigen Testing

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