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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
, 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 (...) Prostatecancer screening Top results for prostatecancer screening - 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
. Association of male circumcision with risk of prostatecancer: a meta-analysis. ProstateCancerProstatic Dis, 2015. 18: 352. 73. Rider, J.R., et al. Ejaculation Frequency and Risk of ProstateCancer: Updated Results with an Additional Decade of Follow-up. Eur Urol, 2016. 70: 974. 74. Brierley, J.D., et al., TNM classification of malignanttumors. UICC International Union Against Cancer. 8th edn. 2017. 75. Cooperberg, M.R., et al. The University of California, San Francisco Cancer of the Prostate Risk (...) of atypical small acinar proliferation. Can J Urol, 2017. 24: 8714. 219. Epstein, J.I., et al. Prostate needle biopsies containing prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma: implications for patient care. J Urol, 2006. 175: 820. 220. Merrimen, J.L., et al. Multifocal high grade prostatic intraepithelial neoplasia is a significant risk factor for prostaticadenocarcinoma. J Urol, 2009. 182: 485. 221. Kronz, J.D., et al. High-grade prostatic intraepithelial neoplasia
screening 24 April 2020 Institute for Quality and Efficiency in Health Care (IQWiG) - 1 - 1 Background Prostatecancer is a malignant change in the prostate; as it progresses, it can infiltrate directly adjacent tissue (seminal vesicle, urinary bladder, large intestine) and can form distant metastases. As measured by the number of new cases, prostatecancer is the most common tumourdisease in men in Germany, making up 23.0% of all cancer cases. For 2016, the Robert Koch Institute estimated that about (...) 58 780 men received an initial diagnosis of prostatecancer . Age is considered the most important risk factor for the development of prostatecancer [1, 2]. At a median age of onset of 72 years, prostatecancer occurs predominantly in advanced age; it is rarely found before the 45 th to 50 th year of life . Every year, about 14 000 men in Germany die of the consequences of prostatecancer . The prognosis of the disease decisively depends on the tumour stage as well as tumour typing
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 prostatecancer screening 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
of malignanttumors. UICC International Union Against Cancer. 8th edn. 2017. 73. Cooperberg, M.R., et al. The University of California, San Francisco Cancer of the Prostate Risk Assessment score: a straightforward and reliable preoperative predictor of disease recurrence after radical prostatectomy. J Urol, 2005. 173: 1938. 74. Epstein, J.I., et al. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of ProstaticCarcinoma. Am J Surg Pathol, 2005. 29: 1228 (...) as predictors for prostatecancer. J Clin Oncol, 2009. 27: 398. 133. Stephan, C., et al. The influence of prostate volume on the ratio of free to total prostate specific antigen in serum of patients with prostatecarcinoma and benign prostate hyperplasia. Cancer, 1997. 79: 104. 134. Catalona, W.J., et al. Use of the percentage of free prostate-specific antigen to enhance differentiation of prostatecancer from benign prostaticdisease: a prospective multicenter clinical trial. JAMA, 1998. 279: 1542. 135
Prostate-Specific Antigen Testing for ProstateCancer: Clinical Utility and Guidelines Prostate-Specific Antigen Testing for ProstateCancer: Clinical Utility and Guidelines | CADTH.ca Find the information you need Prostate-Specific Antigen Testing for ProstateCancer: Clinical Utility and Guidelines Prostate-Specific Antigen Testing for ProstateCancer: Clinical Utility and Guidelines Last updated: August 22, 2019 Project Number: RA1060-000 Product Line: Research Type: Devices and Systems (...) Report Type: Reference List Result type: Report Question What is the clinical utility of prostate-specific antigen testing for prostatecancer? What are the evidence-based guidelines on the use of prostate-specific antigen testing for prostatecancer screening? Key Message Two systematic reviews were identified regarding the clinical utility of prostate-specific antigen testing for prostatecancer. In addition, five evidence-based guidelines were identified regarding the use of prostate-specific
to be followed. Monitor more closely men with abnormal findings on pre-biopsy digital rectal examination, and those whose biopsy findings included either atypical small acinar proliferation or high-grade prostatic intra-epithelial neoplasia. In addition to further PSA testing and digital rectal examination, consider prostate imaging with investigations that can help to localise the site of cancer within the prostate, and repeat biopsy using a targeted approach. EBR (D) 3.2 8.1, 8.2xiii SUMMARY OF CLINICAL (...) men per 1000 at a cost of 230 unnecessary biopsies per 1,000 men tested; and with testing at 55-70 years and a testing interval of 1 year, the reduction in metastatic disease at diagnosis was 2.6 men per 1,000 at a cost of 185 unnecessary biopsies per 1000 men tested. Expressed in approximately equivalent terms to those of Table 2.3, increasing the frequency of testing from four- yearly to yearly increases the probability that diagnosis with metastatic prostatecancer is prevented by 0.06
the disease, while preserving continence and, if possible, potency  (B0001). Radiation therapy (RT) is another definitive treatment strategy in which a therapeutic dose of radi- ation is delivered to the tumour (either as external beam, brachytherapy, or a combination of both) while minimising the radiation to normal tissue. External beam RT (EBRT) utilises an external source of radiation to treat the prostate gland and a margin of adjacent normal tissue. Brachy- therapy directly implants a radioactive (...) source within the prostate, thus providing the highest dose of radiation. Its aim is to maximise irradiation of the tumour while minimising radiation to normal tissue  (B0001). Health problem PCa is the most common non-skin cancer in men in Europe . Localised PCa is often indolent, and has no impact on health, even without treatment [12-14] (A0002). The incidence of PCa is higher in Northern and Western Europe compared with other areas of Europe, whereas incidence rates in Eastern and Southern
Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostatecancer. Multiparametric magnetic resonance imaging (MRI), with or without MRI-targeted biopsy, is an alternative test to systematic transrectal ultrasonography-guided biopsy in men suspected of having prostatecancer. At present, evidence on which test to use is insufficient to inform detailed evidence-based decision-making.To determine the diagnostic accuracy of the index tests MRI only, MRI (...) -targeted biopsy, the MRI pathway (MRI with or without MRI-targeted biopsy) and systematic biopsy as compared to template-guided biopsy as the reference standard in detecting clinically significant prostatecancer as the target condition, defined as International Society of Urological Pathology (ISUP) grade 2 or higher. Secondary target conditions were the detection of grade 1 and grade 3 or higher-grade prostatecancer, and a potential change in the number of biopsy procedures.We performed
for prostatecancer using prostate-specific antigen (PSA) testing. STATEMENT OF THE CLINICAL ISSUE Section: Prostatecancer is the second leading cause of cancer deaths among men in the United States, , with the estimated number of deaths exceeding 28,000 in 2012. The rationale for screening asymptomatic men for prostatecancer in the general population is the potential for reducing mortality rates through early detection of the disease. However, much controversy exists between the potential harms (...) will ultimately be diagnosed with low-risk disease, which may not have presented itself clinically over their lifetimes. For men with low-risk disease who seek treatment, it is not clear if the risk of dying as a result of prostatecancer, or any other cause, is reduced compared with men who chose active surveillance. , In the Swedish study in which men were randomly assigned to surgery or watchful waiting, cancer-specific survival was higher among men who underwent surgery. However, the study patients did
Prostate-Specific Antigen (PSA)?based population screening for prostatecancer: an evidence-based analysis Prostate-Specific Antigen (PSA)–based population screening for prostatecancer: an evidence-based analysis Prostate-Specific Antigen (PSA)–based population screening for prostatecancer: an evidence-based analysis Pron G Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been (...) made for the HTA database. Citation Pron G. Prostate-Specific Antigen (PSA)–based population screening for prostatecancer: an evidence-based analysis. Toronto: Health Quality Ontario (HQO). Ontario Health Technology Assessment Series; 15(10). 2015 Authors' conclusions None of the systematic reviews of the randomized controlled screening trials for PC found a statistically significant reduction in relative risk of PC mortality or overall mortality with PSA-based population screening programs
the Committee, issued a positive opinion for granting a marketing authorisation to Tookad on 14 September 2017. 2. Scientific discussion 2.1. Problem statement 2.1.1. Disease or condition Tookad is indicated as monotherapy for adult patients with previously untreated, unilateral, low-risk, adenocarcinoma of the prostate with a life expectancy = 10 years and: - Clinical stage T1c or T2a, - Gleason Score = 6, based on high-resolution biopsy strategies, - PSA = 10 ng/mL, - 3 positive cancer cores (...) Padeliporfin (Tookad) - prostatecancer / ProstaticNeoplasms 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact 14 September 2017 EMA/644309/2017 Committee for Medicinal Products for Human Use (CHMP) Assessment report TOOKAD International non-proprietary name: padeliporfin Procedure No. EMEA/H/C/004182/0000 Note Assessment report
MBS items to cover the urological component and radiation oncology component of LDR-BT for use as a boost to EBRT in patients with high- intermediate and high-risk prostatecancer. The proposed MBS item descriptors are summarised in Table 1. 4 Table 1 Applicant proposed MBS item descriptor Category 3 – Therapeutic procedures PROSTATE, radioactive seed implantation (radiation oncology component), using transrectal ultrasound guidance, for localised (non-metastatic) prostaticmalignancy classified (...) (urological component), using transrectal ultrasound guidance, for localised (non-metastatic) prostaticmalignancy classified as high-intermediate risk (defined as having a prostate specific antigen (PSA) of 10-20 ng/ml and a Gleason score of 7 and a tumour classified as T2b-c) or high risk (defined as having a PSA of greater than 20 ng/ml and/or a Gleason score of 8-10 and/or a tumour classified as T3). It is recommended the procedure only be performed as ‘boost’ treatment, in addition to external beam
in Ireland, 2010-2012 87 Figure 7 Five year net survival: ProstateCancer in Ireland 88 Figure 8 Economic Literature Review Results 1377 | A National Clinical Guideline | Diagnosis, staging and treatment of patients with prostatecancerCancer is a major healthcare challenge. Each year in Ireland, approximately 19,000 people are diagnosed with malignantcancer. Cancer is the second leading cause of death in Ireland after diseases of the circulatory system. Deaths from cancer averaged about 8,800 deaths (...) at three levels. (C) 126.96.36.199 For determining tumour extent in prostate core biopsies, when there are multiple foci of prostatecancer in a single core separated by benign intervening stroma, it is suggested that the collapsing method is used (i.e. where intervening benign tissue is excluded from the measurement). (D) 188.8.131.52 For each biopsy site the presence of biopsies positive for carcinoma and the ISUP 2005 Gleason score should be reported. The pathologists should assign a separate Gleason score
be offered as an alternative to conventional fractionation. The task force strongly encourages that these patients be treated as part of a clinical trial or multi-institutional registry. Comment: There is additional RCT evidence to support the recommendation of KQ3B that may increase the quality of evidence for the use of ultrahypofractionation in intermediate-risk disease from low to at least moderate . ENDORSED with comment KQ3C: In men with high-risk prostatecancer receiving EBRT, the task force (...) with the recommendations for information purposes. Guideline Endorsement 3-22 Section 2: Endorsement Methods Overview – April 28, 2020 Page 5 Selection of Guidelines The Radiation Treatment Program, Disease Pathway Management, Ontario GU Cancers Advisory Committee, GU disease site group (DSG) chairs reviewed the ASTRO, ASCO, and AUA evidence-based guideline on hypofractionated radiation therapy for localized prostatecancer and accepted it as potentially useful and relevant to guide practice in Ontario. Assessment
-staging 29 184.108.40.206 Alkaline phosphatase 29 220.127.116.11 Bone scan 29 5.3.4 New imaging modalities 29 18.104.22.168 Nodal metastases 29 22.214.171.124 Bone metastasis 30 5.3.5 Guidelines for staging of prostatecancer 30 6. DISEASE MANAGEMENT 30 6.1 Treatment: Deferred treatment (active surveillance/watchful waiting) 30 6.1.1 Introduction 30 126.96.36.199 Definition 30 188.8.131.52.1 Active surveillance 30 184.108.40.206.2 Watchful waiting 31 6.1.2 Deferred treatment of localised PCa (stage T1/T2, Nx/N0, M0) 31 220.127.116.11 Active (...) advanced Conclusions and recommendations have been rephrased and added to throughout the current document. Changed or new conclusions and recommendations can be found in sections: 18.104.22.168 Guidelines for imaging LE GR When clinical suspicion of PCa persists in spite of negative biopsies, MRI-targeted biopsies are recommended. 2b B10 PROSTATECANCER - UPDATE MARCH 2015 Table 5.2.4: Recommended terminology for reporting prostate biopsies  • Benign/negative for malignancy. If appropriate, include
Hypofractionated Radiation Therapy for Localized ProstateCancerProstateCancer: Hypofractionated Radiotherapy Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology (...) is considered low compared to most other neoplasms, with several estimates derived from large populations in the range of 100 to 200 cGy. 5-7 Unlike other solid tumors with higher alpha-beta ratios, the alpha-beta ratio of the adjacent dose-limiting normal structure, namely the rectum, has been estimated to be greater than that of prostatecancer itself. 8,9 An implication of this relationship is that hypofractionation - daily delivery of EBRT with fraction sizes >200 cGy - may further improve
prognostic models and enhanced prebiopsy imaging are mandatory. An essential consideration when implementing any tissue-based biomarker study in prostatecancer is that tissue-based molecular testing is dependent on the site of collection within the primary tumor and tumor content, and is significantly influenced by the heterogeneity of the disease. , , For the purpose of improving prognostic value, it is of paramount importance to select the areas that are characterized by the most aggressive disease (...) . were Expert Panel co-chairs. Abstract Section: PURPOSE This guideline provides recommendations for available tissue-based prostatecancer biomarkers geared toward patient selection for active surveillance, identification of clinically significant disease, choice of postprostatectomy adjuvant versus salvage radiotherapy, and to address emerging questions such as the relative value of tissue biomarkers compared with magnetic resonance imaging. METHODS An ASCO multidisciplinary Expert Panel