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Latest & greatest articles for prostate cancer screening
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with 4-yr intervals starting at age 55yr and screened up to the age of 74yr. Overall, a PSA level of ≥3.0ng/ml triggered biopsy. At time of analysis, 63% of men had died. Overall relative risk of metastatic (M+) disease and prostatecancer (PCa) death was 0.46 (95% confidence interval [CI]: 0.19-1.11) and 0.48 (95% CI: 0.17-1.36), respectively, in favor of screening. This ERSPC Rotterdam pilot 1 study cohort, screened in a period without noteworthy contamination, shows that PSA-based screening could (...) result in considerable reductions of M+ disease and mortality which if confirmed in larger datasets should trigger further discussion on pros/cons of PCa screening. PATIENT SUMMARY: In a cohort with 19yr of follow-up, we found indications for a more substantial reduction in metastatic disease and cancer-specific mortality in favor of prostatecancerscreening than previously reported. If confirmed in larger cohorts, these findings should be considered in the ongoing discussion on harms and benefits
users and nonusers using an age-adjusted Cox regression model.Screening increased the detection of Gleason 6 (hazard ratio [HR] 1.59, 95% confidence interval [CI] 1.47-1.72 and HR 1.39, 95% CI 1.26-1.54) and localized prostatetumors (HR 1.25, 95% CI 1.18-1.32 and HR 1.11, 95% CI 1.03-1.20) more among baseline NSAID nonusers than among users, respectively (p for interaction <0.04 for both). This difference was observed in all three screening rounds. Detection of metastatic prostatecancer (...) was similar in both NSAID users and nonusers. Screening decreased prostatecancer mortality among men using NSAIDs at FinRSPC randomization (HR 0.66, 95% CI 0.49-0.90) but not among nonusers (HR 0.95, 95% CI 0.81-1.12); p for interaction=0.04.Screening detected fewer well-differentiated localized tumors among NSAID users than among nonusers. This suggests that PSA screening may cause less overdiagnosis within this subgroup, whereas mortality benefit may be greater among NSAID users.Prostate cancer
1000 men screened over 10 years. Direct comparative data on biopsy and treatment related complications from the included trials were limited. Using modelling, we estimated that for every 1000 men screened, approximately 1, 3, and 25 more men would be hospitalised for sepsis, require pads for urinary incontinence, and report erectile dysfunction, respectively.At best, screening for prostatecancer leads to a small reduction in disease-specific mortality over 10 years but has does not affect overall (...) Prostatecancerscreening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. To investigate the efficacy and safety of prostate-specific antigen (PSA) testing to screen for prostate cancer.Systematic review and meta-analysis.Electronic search of Cochrane Central Register of Controlled Trials, Web of Science, Embase, Scopus, OpenGrey, LILACS, and Medline, and search of scientific meeting abstracts and trial registers to April 2018.Randomised controlled trials
, prostate biopsy, prostatecancer diagnosis, and definitive local treatment were determined using associated International Classification of Diseases, Ninth Revision and Current Procedural Terminology, Fourth Edition codes. RESULTS: There were approximately 6 million qualifying men with a full year of data. PSA 2018 8. Harms of Prostate -Specific Antigen ( PSA ) screening in prostatecancer : a rapid review Harms of Prostate -Specific Antigen ( PSA ) screening in prostatecancer : a rapid review Harms (...) Prostatecancerscreening Top results for prostatecancerscreening - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search
Screening for ProstateCancer: US Preventive Services Task Force Recommendation Statement. In the United States, the lifetime risk of being diagnosed with prostatecancer is approximately 13%, and the lifetime risk of dying of prostatecancer is 2.5%. The median age of death from prostatecancer is 80 years. Many men with prostatecancer never experience symptoms and, without screening, would never know they have the disease. African American men and men with a family history of prostatecancer (...) have an increased risk of prostatecancer compared with other men.To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on prostate-specific antigen (PSA)-based screening for prostate cancer.The USPSTF reviewed the evidence on the benefits and harms of PSA-based screening for prostatecancer and subsequent treatment of screen-detected prostatecancer. The USPSTF also commissioned a review of existing decision analysis models and the overdiagnosis rate of PSA-based screening
after abnormal screening findings. Overdiagnosis was estimated to occur in 20.7% to 50.4% of screen-detected cancers. In an RCT of men with screen-detected prostatecancer (n = 1643), neither radical prostatectomy (hazard ratio [HR], 0.63 [95% CI, 0.21-1.93]) nor radiation therapy (HR, 0.51 [95% CI, 0.15-1.69]) were associated with significantly reduced prostatecancer mortality vs active monitoring, although each was associated with significantly lower risk of metastatic disease. Relative (...) Prostate-Specific Antigen-Based Screening for ProstateCancer: Evidence Report and Systematic Review for the US Preventive Services Task Force. Prostatecancer is the second leading cause of cancer death among US men.To systematically review evidence on prostate-specific antigen (PSA)-based prostatecancerscreening, treatments for localized prostatecancer, and prebiopsy risk calculators to inform the US Preventive Services Task Force.Searches of PubMed, EMBASE, Web of Science, and Cochrane
Effect of a Low-Intensity PSA-Based Screening Intervention on ProstateCancer Mortality: The CAP Randomized Clinical Trial. Prostatecancerscreening remains controversial because potential mortality or quality-of-life benefits may be outweighed by harms from overdetection and overtreatment.To evaluate the effect of a single prostate-specific antigen (PSA) screening intervention and standardized diagnostic pathway on prostatecancer-specific mortality.The Cluster Randomized Trial of PSA Testing (...) stage and Gleason grade (range, 2-10; higher scores indicate a poorer prognosis) of prostatecancers identified, all-cause mortality, and an instrumental variable analysis estimating the causal effect of attending the PSA screening clinic.Among 415 357 randomized men (mean [SD] age, 59.0 [5.6] years), 189 386 in the intervention group and 219 439 in the control group were included in the analysis (n = 408 825; 98%). In the intervention group, 75 707 (40%) attended the PSA testing clinic and 67 313
Polygenic hazard score to guide screening for aggressive prostatecancer: development and validation in large scale cohorts. To develop and validate a genetic tool to predict age of onset of aggressive prostatecancer (PCa) and to guide decisions of who to screen and at what age.Analysis of genotype, PCa status, and age to select single nucleotide polymorphisms (SNPs) associated with diagnosis. These polymorphisms were incorporated into a survival analysis to estimate their effects on age (...) at diagnosis of aggressive PCa (that is, not eligible for surveillance according to National Comprehensive Cancer Network guidelines; any of Gleason score ≥7, stage T3-T4, PSA (prostate specific antigen) concentration ≥10 ng/L, nodal metastasis, distant metastasis). The resulting polygenic hazard score is an assessment of individual genetic risk. The final model was applied to an independent dataset containing genotype and PSA screening data. The hazard score was calculated for these men to test prediction
has published a white paper to provide some guidance regarding periprocedural prophylaxis. Since prostate biopsies are also an important part of some active surveillance programs, understanding these risks and communicating them to patients is not only integral to informed consent for prostatecancerscreening but also for consideration of treatment options. Once diagnosed with prostatecancer, a man is faced with the risk of overtreatment of indolent disease due to the assumption that diagnosis (...) with a malignancy must necessarily result in treatment of this malignancy. Estimates of overdiagnosis vary widely from less than 5% to more than 75% depending upon the population used with lead times of 5 to 15 years. Although prostatecancer specific mortality and the need for related palliative care is decreased by screening, quality of life may be impaired as a result due to lasting impairment in urinary, bowel, and sexual function. There is considerable distress involved in the decision making process
imaging (MRI), bone scan, and computed tomography, are often also performed, especially in men presenting with higher risk disease, to check for disease spread. Screening controversy For many reasons, PSA screening remains controversial. Advocates often base their opinions on the European Randomised study of Screening for ProstateCancer (ERSPC), which suggests that screening may reduce the long term risk of prostatecancer-specific mortality by at least 9% (relative reduction). They also note (...) that substantial observational evidence indicates a reduction in advanced disease and reduction in prostatecancer mortality, which they attribute to the introduction of PSA screening. Opponents of PSA screening highlight the indolent natural course of prostatecancer, citing systematic reviews that reported little or no impact of PSA screening on overall and prostatecancer-specific mortality. Opponents also suggest that the harms and burden from overdiagnosis and overtreatment resulting in unnecessary
common types of cancer that affects men. In the United States, the lifetime risk of being diagnosed with prostatecancer is approximately 11%, and the lifetime risk of dying of prostatecancer is 2.5%. Many men with prostatecancer never experience symptoms and, without screening, would never know they have the disease. In autopsy studies of men who died of other causes, more than 20% of men aged 50 to 59 years and more than 33% of men aged 70 to 79 years were found to have prostatecancer. In some (...) . The CAP trial was a cluster-randomized trial of a single invitation to PSA-based screening in the United Kingdom among 415,357 men. Overall, 34% of invited men received a valid PSA screening test. After a median follow-up of 10 years, there was no significant difference in prostatecancer mortality between the invited group and the control group (absolute risk, 0.30 per 1000 person-years vs 0.31 per 1000 person-years, respectively). Based on clinical stage, tumor grade, and PSA level, prostatecancer
Reconciling the Effects of Screening on ProstateCancer Mortality in the ERSPC and PLCO Trials. The ERSPC (European Randomized Study of Screening for ProstateCancer) found that screening reduced prostatecancer mortality, but the PLCO (Prostate, Lung, Colorectal, and Ovarian CancerScreening Trial) found no reduction.To evaluate whether effects of screening on prostatecancer mortality relative to no screening differed between the ERSPC and PLCO.Cox regression of prostatecancer death in each (...) trial group, adjusted for age and trial. Extended analyses accounted for increased incidence due to screening and diagnostic work-up in each group via mean lead times (MLTs), which were estimated empirically and using analytic or microsimulation models.Randomized controlled trials in Europe and the United States.Men aged 55 to 69 (ERSPC) or 55 to 74 (PLCO) years at randomization.Prostate cancer screening.Prostate cancer incidence and survival from randomization; prostatecancer incidence
Impact of Prostatic-specific Antigen Threshold and Screening Interval in ProstateCancerScreening Outcomes: Comparing the Swedish and Finnish European Randomised Study of Screening for ProstateCancer Centres. The European Randomised Study of Screening for ProstateCancer trial has shown a 21% reduction in prostatecancer (PC) mortality with prostate-specific antigen (PSA)-based screening. Sweden used a 2-yr screening interval and showed a larger mortality reduction than Finland with a 4-yr (...) between the Finnish and Swedish centres and estimated the impact of different screening protocols.If the Swedish screening protocol had been followed in Finland, 122 additional PC cases would have been diagnosed at screening, 84% of which would have been low-risk cancers, and four leading to PC death. In contrast, if a lower PSA threshold had been applied in Finland, at least 127 additional PC would have been found, with 19 PC deaths.The small number of deaths among cases that would have been
you like to save your information to view later? Create an account and sign in to keep your Decision box results and view them later. You can also: Continue without an account and print your profile when the process is completed ProstateCancerScreening Men between the ages of 55 and 69 with at least a 10-year life expectancy. Screening is appropriate for people who do not carry a disease that affects their life expectancy. The prostate-specific antigen (PSA) blood test is used to screen men (...) ProstateCancerScreening Boîte à décision | Box details Back to the Decision boxes × My account Creating an account and signing in will allow you to keep your Decision box results and view them later. I do not have an account Provide some personal information and create a user account allowing to save your Decision box results and view them later. You can also: I already have an account Please enter your email address and password to access your profile and consult your decision boxes. Email
EAU-ESTRO-SIOG Guidelines on ProstateCancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent To present a summary of the 2016 version of the European Association of Urology (EAU) - European Society for Radiotherapy & Oncology (ESTRO) - International Society of Geriatric Oncology (SIOG) Guidelines on screening, diagnosis, and local treatment with curative intent of clinically localised prostatecancer (PCa).The working panel performed a literature review of the new data (...) (2013-2015). The guidelines were updated and the levels of evidence and/or grades of recommendation were added based on a systematic review of the evidence.BRCA2 mutations have been added as risk factors for early and aggressive disease. In addition to the Gleason score, the five-tier 2014 International Society of Urological Pathology grading system should now be provided. Systematic screening is still not recommended. Instead, an individual risk-adapted strategy following a detailed discussion
Psychological Predictors of ProstateCancerScreening Behaviors Among Men Over 50 Years of Age in Hamadan: Perceived Threat and Efficacy Prostatecancer is the fourth most common cancer worldwide and is the second most lethal cancer.The aim of this study was to investigate psychological predictors of prostatecancerscreening behaviors among men over 50 years of age in Hamadan.This cross-sectional study was carried out on 200 men over 50 years of age in Hamadan, west of Iran. Participants were (...) recruited with a cluster sampling method. The subjects completed a self-administered questionnaire including demographic characteristics, prostatecancerscreening behaviors and psychological factors related to prostatecancer. Data was analyzed by SPSS-18 using chi-square, fisher exact test, and logestic regression.According to the results, 8.5 and 7.5 percent of participants reported history of digital rectal exam and prostate-specific antigen test, respectively. Also, the subjects reported 18.5