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Latest & greatest articles for prostate cancer screening
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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
. UroEvidence@Deutsche Gesellschaft für Urologie, Martin-Buber-Straße 10, 14163, Berlin, Deutschland. firstname.lastname@example.org. ger Journal Article Meta-Analysis Systematic Review Prostatakarzinomscreening mittels prostataspezifischem Antigen (PSA) : Ein Kommentar zu einer systematischen Übersichtsarbeit und Metaanalyse. Germany Urologe A 1304110 0340-2592 0 Biomarkers, Tumor EC 184.108.40.206 Prostate-Specific Antigen IM Biomarkers, Tumor blood Early Detection of Cancer Humans Male Mass Screening methods Prostate (...) [Screening for prostatecancer using prostate-specific antigen (PSA) : A commentary on a systematic review and meta-analysis]. 31240375 2019 09 26 2020 03 09 1433-0563 58 8 2019 08 Der Urologe. Ausg. A Urologe A [Screening for prostatecancer using prostate-specific antigen (PSA) : A commentary on a systematic review and meta-analysis]. 925-928 10.1007/s00120-019-0990-6 Borkowetz A A Klinik und Poliklinik für Urologie, Universitätsklinikum Dresden, Dresden, Deutschland. email@example.com
Decision Aids for ProstateCancerScreening Choice: A Systematic Review and Meta-analysis. US guidelines recommend that physicians engage in shared decision-making with men considering prostatecancer screening.To estimate the association of decision aids with decisional outcomes in prostatecancer screening.MEDLINE, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL were searched from inception through June 19, 2018.Randomized trials comparing decision aids for prostatecancerscreening with usual (...) with whether physicians and patients discuss prostatecancerscreening (risk ratio, 1.12; 95% CI, 0.90-1.39; I2 = 60%; low quality) or with men's decision to undergo prostatecancerscreening (risk ratio, 0.95; 95% CI, 0.88-1.03; I2 = 36%; low quality).The results of this study provide moderate-quality evidence that decision aids compared with usual care are associated with a small decrease in decisional conflict and low-quality evidence that they are associated with an increase in knowledge
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
Current guidelines for prostatecancerscreening: A systematic review and minimal core proposal. Considering the importance of screening for prostatecancer, the possibility of damage resulting from indiscriminate screening and the difficulty of disclosure and adherence to the main guidelines on the subject, we aimed to identify current guidelines, look for common approaches and establish a core of conducts.Systematic review of the literature on screening practice guidelines for prostatecancer (...) searching the databases PubMed, Lilacs and Google Scholar and active search in the sites of several national health entities.Twelve (12) guidelines were selected, whose analysis resulted in the identification of six common points of conduct, with the following minimum core of recommendations: (1) screening indication or not: must be individualized, and preceded by an informed decision; (2) tests used: PSA with or without rectal digital examination; (3) age at which initiate testing in men in general
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
Correction to: The effects of shared decision-making compared to usual care for prostatecancerscreening decisions: a systematic review and meta-analysis. Following publication of the original article , the authors notified us of a misleading data presentation in Table 4.
The effects of shared decision-making compared to usual care for prostatecancerscreening decisions: a systematic review and meta-analysis. Shared decision-making (SDM) is recommended for men facing prostatecancer (PC) screening decisions. We synthesize the evidence on the comparative effectiveness of SDM with usual care.We searched academic and grey literature databases, and other sources for primary randomised controlled trials (RCTs) published in English comparing SDM to usual care (...) participation in prostate-specific antigen (PSA) testing (RR 1.03, 95%CI 0.90 to 1.19; 2 RCTs) or decisional conflict (SMD -0.04, 95%CI -0.23 to 0.15; SMD -0.05, 95%CI -0.24 to 0.14; 2 RCTs). Individual trial estimates (46.7%) also suggest that SDM may reduce or neutralise physicians' tendency for PSA screening, and may improve the accuracy of patients' perception of lifetime-risks and men's views towards screening. There was no evidence on the effects of SDM on health outcomes. The studies represent
ProstateCancerScreening Patient Decision Aids:A Systematic Review and Meta-analysis. Although screening recommendations for prostatecancer using prostate-specific antigen testing often include shared decision making, the effect of patient decision aids on patients' intention and uptake is unclear. This study aimed to review the effect of decision aids on men's screening intention, screening utilization, and the congruence between intentions and uptake.Data sources were searched through April (...) 6, 2018, and included MEDLINE, Scopus, CENTRAL, CT.gov, Cochrane report, PsycARTICLES, PsycINFO, and reference lists. This study included RCTs and observational studies of decision aids that measured prostatescreening intention or behavior. The analysis was completed in April 2018.Eighteen studies (13 RCTs, four before-after studies, and one non-RCT) reported data on screening intention for ≅8,400 men and screening uptake for 2,385 men. Compared with usual care, the use of decision aids in any
Values and preferences of men for undergoing prostate-specific antigen screening for prostatecancer: a systematic review. To investigate men's values and preferences regarding prostate-specific antigen (PSA)-based screening for prostate cancer.Systematic review.We searched MEDLINE, EMBASE, PsycINFO and grey literature up to 2 September 2017.Primary studies of men's values and preferences regarding the benefits and harms of PSA screening.Two independent reviewers extracted data and assessed (...) considerably in the reporting of outcomes. Two studies suggested that men were willing to forego screening with a small benefit in prostatecancer mortality if it would decrease the likelihood of unnecessary treatment or biopsies. In contrast, one study reported that men were willing to accept a substantial overdiagnosis to reduce their risk of prostatecancer mortality. Among the six studies involving decision aids, willingness to undergo screening varied substantially from 37% when displaying
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
Web-Based Versus Usual Care and Other Formats of Decision Aids to Support ProstateCancerScreening Decisions: Systematic Review and Meta-Analysis. Prostatecancer is a leading cause of cancer among men. Because screening for prostatecancer is a controversial issue, many experts in the field have defended the use of shared decision making using validated decision aids, which can be presented in different formats (eg, written, multimedia, Web). Recent studies have concluded that decision aids (...) improve knowledge and reduce decisional conflict.This meta-analysis aimed to investigate the impact of using Web-based decision aids to support men's prostatecancerscreening decisions in comparison with usual care and other formats of decision aids.We searched PubMed, CINAHL, PsycINFO, and Cochrane CENTRAL databases up to November 2016. This search identified randomized controlled trials, which assessed Web-based decision aids for men making a prostatecancerscreening decision and reported quality
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
Shared decision-making for prostatecancerscreening and treatment: a systematic review of randomised controlled trials. Men facing prostatecancerscreening and treatment need to make critical and highly preference-sensitive decisions that involve a variety of potential benefits and risks. Shared decision-making (SDM) is considered fundamental for "preference-sensitive" medical decisions and it is guideline-recommended. There is no single definition of SDM however. We systematically reviewed (...) the extent of SDM implementation in interventions to facilitate SDM for prostatecancerscreening and treatment.We searched Medline Ovid, Embase (Elsevier), CINHAL (EBSCOHost), The Cochrane Library (Wiley), PsychINFO (EBSCOHost), Scopus, clinicaltrials.gov, ISRCTN registry, the WHO search portal, ohri.ca, opengrey.eu, Google Scholar, and the reference lists of included studies, clinical guidelines and relevant reviews. We also contacted the authors of relevant abstracts without available full text. We
Cost-effectiveness of prostatecancerscreening: a systematic review of decision-analytical models. There is ongoing debate about the harms and benefits of a national prostatecancerscreening programme. Several model-based cost-effectiveness analyses have been developed to determine whether the benefits of prostatecancerscreening outweigh the costs and harms caused by over-detection and over-treatment, and the different approaches may impact results.To identify models of prostatecancer used (...) to assess the cost-effectiveness of prostatecancerscreening strategies, a systematic review of articles published since 2006 was conducted using the NHS Economic Evaluation Database, Medline, EMBASE and HTA databases. The NICE website, UK National Screening website, reference lists from relevant studies were also searched and experts contacted. Key model features, inputs, and cost-effectiveness recommendations were extracted.Ten studies were included. Four of the studies identified some screening