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

2013 ◽  
Vol 5 (6) ◽  
pp. 416
Author(s):  
G. Michael Allan ◽  
Michael P. Chetner ◽  
Bryan J. Donnelly ◽  
Neil A. Hagen ◽  
David Ross ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Prostate Cancer Screening ◽  
Poor Quality ◽  
Good Evidence ◽  
Screening Programs ◽  
Fecal Occult ◽  
Actual Compliance ◽  
Specific Mortality ◽  
Cancer Specific Mortality

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.

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 ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Prostate Cancer Screening ◽  
Specific Mortality ◽  
Cancer Specific Mortality

Obstacles in prostate cancer screening: Current issues and future solutions

2018 ◽  
Vol 12 (2) ◽  
pp. 111-116
Author(s):  
Benjamin Patel ◽  
Seshadri Sriprasad ◽  
Jeffrey Cadeddu ◽  
Arron Thind ◽  
Abhay Rane
Keyword(s):  
Prostate Cancer ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Diagnostic Value ◽  
Good Evidence ◽  
Screening Methods ◽  
Level Of Evidence ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Clinically Significant

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

scholarly journals Prostate Cancer Screening in the Workplace

AAOHN Journal ◽  
1998 ◽  
Vol 46 (8) ◽  
pp. 379-384 ◽  
Author(s):  
Claire Snyder ◽  
Peggy N. Schrammel ◽  
Claudia B. Griffiths ◽  
Robert I. Griffiths
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Screening Tests ◽  
Test Results ◽  
Total Cost ◽  
Screening Programs ◽  
Psa Testing ◽  
The Cost

Recognition of the mortality and morbidity associated with prostate cancer has resulted in employer based screening programs. This retrospective cohort study identified the employer costs of prostate cancer screening and referrals due to abnormal test results. The subjects were 385 men enrolled in a workplace screening program at a single employer between 1993 and 1995. Screening consisted of digital rectal examination (DRE) annually for enrolled employees aged 40 years and older, plus annual prostate specific antigen (PSA) testing for those 50 and older, and those 40 and older and considered at high risk. Data related to the health care and lost productivity costs of screening and referrals for abnormal test results were collected and analyzed. The total cost of screening was $44,355, or approximately $56 per screening encounter (788 DREs; 437 PSAs). Abnormal screening tests resulted in 52 referrals. Upon further evaluation, 42% were found to have an enlargement, 29% a node, and 12% benign prostatic hyperplasia. Only one malignancy was found. The total cost of additional referrals was $31,815, or 42% of the cost of screening plus referrals. As the cost per screening encounter was low, prostate cancer screening in the workplace is an efficient alternative.

Cancer screening in France: 3rd edition of the EDIFICE survey.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1568-1568
Author(s):  
Jérôme Viguier ◽  
Francois Eisinger ◽  
Yvan Coscas ◽  
Jean F. Morere ◽  
Jean-Yves Blay ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Test ◽  
Prostate Cancer Screening ◽  
Age Groups ◽  
Target Population ◽  
Screening Programs

1568 Background: The EDIFICE survey program started in 2005 and was aimed at providing a better understanding of the participation of the French population in cancer screening programs and assess the evolution over time. The EDIFICE 3 survey was conducted in 2011, following EDIFICE 1 (2005) and EDIFICE 2 (2008), and focused on colorectal, breast and prostate cancer. Methods: This third nationwide observational study, EDIFICE 3, was conducted by phone interviews among a representative sample of 1603 subjects aged between 40 and 75 years, using the quota method. The analysis focused on the target population of the national screening programs for breast and colorectal cancer (50-74 years). The same population was analysed for prostate cancer screening behaviours. Results: For breast cancer, the rate of women attending at least one screening test was 93%/94%/95% in 2005/2008/2011 respectively. A mammography had been performed as recommended within the last two years for 75%/83%/83% among them. We observed an increase in timing compliance between 2005 and 2011, significant for women aged 65-74. For colorectal cancer, the rate of subjects attending at least one screening test was 25%/38%/59%. A fecal test or colonoscopy had been performed according to the recommended timing for NA/30%/51% among them. Colorectal cancer screening has increased significantly in all age groups, especially between 65 and 69 years, and for both genders. For prostate cancer, the rate of men having performed at least one screening test (PSA and/or rectal examination) was 36%/49%/50%.This rate have significantly decreased in men aged 50-59 between 2008 and 2011(44% vs 37%, p<0.05). Conclusions: For National Programs, the attendance rate remains high for breast cancer screening and is improving for colorectal cancer screening. However, the European guideline objective rate of participation for colorectal cancer screening has not yet been reached. Despite the absence of recommendations, prostate cancer screening is frequently carried out and stable overall.

Impact of screening and treatment on racial and ethnic differences in health service use, cost, and mortality among advanced (T3 or greater) prostate cancer patients.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 131-131
Author(s):  
S. Bruce Malkowicz ◽  
Sumedha Chhatre ◽  
Sanford Schwartz ◽  
Ravishankar Jayadevappa
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Health Service ◽  
Ethnic Differences ◽  
Service Use ◽  
Prostate Cancer Screening ◽  
Age Groups ◽  
Health Service Use ◽  
Specific Mortality ◽  
Racial Ethnic

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.

scholarly journals Pearls for Prostate Cancer Screening

2017 ◽  
Vol 13 (02) ◽  
pp. 79
Author(s):  
Monique J Roobol ◽  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Prostate Cancer Screening ◽  
Huge Amount ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Disease Specific ◽  
Screening Trials

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.

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