scholarly journals Furthering the prostate cancer screening debate (prostate cancer specific mortality and associated risks)

2011 ◽  
Vol 5 (6) ◽  
pp. 416-421 ◽  
Author(s):  
G. Michael Allan ◽  
Michael P. Chetner ◽  
Bryan J. Donnelly ◽  
Neil A. Hagen ◽  
David Ross ◽  
...  
2013 ◽  
Vol 5 (6) ◽  
pp. 416
Author(s):  
G. Michael Allan ◽  
Michael P. Chetner ◽  
Bryan J. Donnelly ◽  
Neil A. Hagen ◽  
David Ross ◽  
...  

Screening for prostate cancer remains a contentious issue. As withother cancer screening programs, a key feature of the debate isverification of cancer-specific mortality reductions. Unfortunatelythe present evidence, two systematic reviews and six randomizedcontrolled trials, have reported conflicting results. Furthermore, halfof the studies are poor quality and the evidence is clouded by keyweaknesses, including poor adherence to screening in the interventionarm or high rates of screening in the control arm. In highquality studies of prostate cancer screening (particularly prostatespecificantigen), in which actual compliance was anticipated inthe study design, there is good evidence that prostate cancer mortalityis reduced. The numbers needed to screen are at least as goodas those of mammography for breast cancer and fecal occult bloodtesting for colo-rectal cancer. However, the risks associated withprostate cancer screening are considerable and must be weighedagainst the advantage of reduced cancer-specific mortality. Adverseevents include 70% rate of false positives, important risks associatedwith prostate biopsy, and the serious consequences of prostatecancer treatment. The best evidence demonstrates prostate cancerscreening will reduce prostate cancer mortality. It is time for thedebate to move beyond this issue, and begin a well-informed discussionon the remaining complex issues associated with prostatecancer screening and appropriate management.


2018 ◽  
Vol 12 (2) ◽  
pp. 111-116
Author(s):  
Benjamin Patel ◽  
Seshadri Sriprasad ◽  
Jeffrey Cadeddu ◽  
Arron Thind ◽  
Abhay Rane

Prostate cancer is the most common cancer in men and is associated with unacceptably high mortality rates, yet an accurate and acceptable screening programme that detects clinically significant prostate cancer remains elusive. Although there is good evidence that prostate-specific antigen (PSA)-based screening lowers prostate cancer-specific mortality, especially when conducted at high intensity, the harm caused by overinvestigation, overdiagnosis and overtreatment of clinically insignificant cases arguably outweighs these benefits. Several attempts have therefore been made to improve screening, enhancing the diagnostic value of PSA and identifying novel modalities for screening. Here, we provide a comprehensive review of the benefits and harms, and analyse which of these novel screening methods show most promise. Level of evidence: 5, expert opinion


2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 131-131
Author(s):  
S. Bruce Malkowicz ◽  
Sumedha Chhatre ◽  
Sanford Schwartz ◽  
Ravishankar Jayadevappa

131 Background: Limited information is available regarding the association between race/ethnicity, health service use, cost, and mortality in older patients with advanced (T3 or greater) stage prostate cancer. The objective is to analyze the race/ethnic differences in mortality, cost, and assess the mediating effect of prostate cancer screening and treatment on these differences in fee-for-service Medicare patients with advanced prostate cancer Methods: Retrospective, observational, case-control study using SEER-Medicare linked data. Cohort consisted of 15,054 elderly men diagnosed with advanced stage prostate cancer between 2001and 2004 and followed retrospectively for up to 2009. Cancer-free controls from Medicare data were used to determine the incremental cost of advanced stage prostate cancer. Racial/ethnic variation in health service use, cost, and mortality were analyzed using Poisson, GLM log-link, and Cox regression models. Results: For the age 66 to 75 and 76 to 85, age groups, racial/ethnic differences in health service use, cost, and all cause mortality were observed. Blacks were less likely to have received prostate cancer screening in the year prior to diagnosis of advanced prostate cancer, less likely to have received any treatment after diagnosis and had higher disease specific mortality. After adjusting for prostate cancer screening and treatment across age groups however, odds of prostate cancer-specific mortality were comparable between racial/ethnic groups suggesting that screening may have some mitigating effect on outcomes in the AA population HR 1.23 (1.07-1.41) versus HR 1.12(0.98-1.29). Conclusions: The pattern of racial/ethnic disparity varies by age group with higher mortality among black men. This may be attributable to disparity in prostate cancer screening or treatment. This suggests that the lack of consideration for racial considerations in the U.S. Preventive Services Task Force PSA recommendations could have disparate racial impact.


2017 ◽  
Vol 13 (02) ◽  
pp. 79
Author(s):  
Monique J Roobol ◽  

Prostate cancer screening and its effect on disease-specific mortality has been a topic of debate since the early 1990s. In 2009, after publication of the results of two large randomized prostate cancer screening trials showing contradictory results, the debate continued. Meanwhile, based on the huge amount of data from these two trials it became clear there is no one-size-fits-all for prostate cancer screening. Now, with two recent publications, the debate on whether prostate cancer screening affects mortality can finally be ended. The focus is on how to identify those men that can benefit from screening.


2010 ◽  
Vol 9 (2) ◽  
pp. 304
Author(s):  
P.J. Van Leeuwen ◽  
R. Kranse ◽  
T. Hakulinen ◽  
M.J. Roobol ◽  
C.H. Bangma ◽  
...  

2010 ◽  
Vol 17 (4) ◽  
pp. 204-210 ◽  
Author(s):  
Pim J van Leeuwen ◽  
Ries Kranse ◽  
Timo Hakulinen ◽  
Monique J Roobol ◽  
Harry J de Koning ◽  
...  

2007 ◽  
Vol 177 (4S) ◽  
pp. 342-342
Author(s):  
Jochen Walz ◽  
Georg Salomon ◽  
Paul Perrotte ◽  
Andrea Gallina ◽  
Georg C. Hutterer ◽  
...  

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