Screening for prostate cancer

Abstract

Given that only two randomised controlled trials were included, and the high risk of bias of both trials, there is insufficient evidence to either support or refute the routine use of mass, selective or opportunistic screening compared to no screening for reducing prostate cancer mortality. Currently, no robust evidence from randomised controlled trials is available regarding the impact of screening on quality of life, harms of screening, or its economic value. Results from two ongoing large scale multicentre randomised controlled trials that will be available in the next several years are required to make evidence-based decisions regarding prostate cancer screening.

Prostate cancer screening in Switzerland: 20-year trends and socioeconomic disparities

“…However, because of conflicting evidence that the potential benefits of screening in reducing mortality may not outweigh the harm of overdiagnosis and the over-treatment of such diagnosis (Ilic et al, 2013;Kim and Andriole, 2015), most organizations including the U.S. Preventive Services Task Force currently recommend against PSA-based screening for prostate cancer. Recent guidelines from the European Association of Urology (2013), the American Urological Association (2013) and the American Cancer Society (2010) emphasize informeddecision making for PCa screening (Heidenreich et al, 2014;Ilic et al, 2013;Wolf et al, 2010).…”

“…Recent guidelines from the European Association of Urology (2013), the American Urological Association (2013) and the American Cancer Society (2010) emphasize informeddecision making for PCa screening (Heidenreich et al, 2014;Ilic et al, 2013;Wolf et al, 2010). Informed-decision making involves patients considering the pros and cons of screening considering the options together with personal values, and making a decision (Bowen et al, 2011).…”

Active surveillance in Canadian men with low-grade prostate cancer

“…1 Screening based on serum prostate-specific antigen (PSA) has been used with the aim of detecting prostate cancer at an early stage, thus increasing the likelihood of successful treatment. 2 However, clinical practice guidelines recently published by the United States Preventive Services Task Force 3 and the Canadian Task Force on Preventive Health Care 4 have recommended against routine PSA screening, partly because of the risk of overdiagnosis and overtreatment of clinically indolent disease. Other groups, such as the American College of Physicians, 5 have recommended a shared decision-making approach between patients and clinicians, recognizing the limitations and possible harms of screening.…”

GRADE EVIDENCE TO DECISION (EtD) FRAMEWORK FOR COVERAGE DECISIONS

“…In the scenario in Table 1, evidence of the effects of screening for prostate cancer came from a Cochrane systematic review (19). The review found that screening has little or no effect on all-cause mortality and cancer-specific mortality, with moderate certainty of the evidence from randomized trials (see definition in Supplementary File 1).…”