Screening Coverage Needed to Reduce Mortality from Prostate Cancer: A Living Systematic Review

Rahal, A.; Badgett, Robert G.; Hoffman, Richard M.

doi:10.1371/journal.pone.0153417

Cited by 16 publications

(11 citation statements)

References 33 publications

(44 reference statements)

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“…Protocols for living pairwise and network meta-analyses have been published recently, 56 57 58 and health technology assessment agencies, the World Health Organization, and drug licensing bodies have recognised the value of synthesising direct and indirect evidence in network meta-analysis. 19 21 41 59 The concept of living meta-analysis is in line with the goal to continuously update guidelines and to promptly translate results to recommendations, evidence summaries, and decision aids.…”

Section: Discussionmentioning

confidence: 99%

Living network meta-analysis compared with pairwise meta-analysis in comparative effectiveness research: empirical study

Nikolakopoulou

Mavridis

Furukawa

et al. 2018

BMJ

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ObjectiveTo examine whether the continuous updating of networks of prospectively planned randomised controlled trials (RCTs) (“living” network meta-analysis) provides strong evidence against the null hypothesis in comparative effectiveness of medical interventions earlier than the updating of conventional, pairwise meta-analysis.DesignEmpirical study of the accumulating evidence about the comparative effectiveness of clinical interventions.Data sourcesDatabase of network meta-analyses of RCTs identified through searches of Medline, Embase, and the Cochrane Database of Systematic Reviews until 14 April 2015.Eligibility criteria for study selectionNetwork meta-analyses published after January 2012 that compared at least five treatments and included at least 20 RCTs. Clinical experts were asked to identify in each network the treatment comparison of greatest clinical interest. Comparisons were excluded for which direct and indirect evidence disagreed, based on side, or node, splitting test (P<0.10).Outcomes and analysisCumulative pairwise and network meta-analyses were performed for each selected comparison. Monitoring boundaries of statistical significance were constructed and the evidence against the null hypothesis was considered to be strong when the monitoring boundaries were crossed. A significance level was defined as α=5%, power of 90% (β=10%), and an anticipated treatment effect to detect equal to the final estimate from the network meta-analysis. The frequency and time to strong evidence was compared against the null hypothesis between pairwise and network meta-analyses.Results49 comparisons of interest from 44 networks were included; most (n=39, 80%) were between active drugs, mainly from the specialties of cardiology, endocrinology, psychiatry, and rheumatology. 29 comparisons were informed by both direct and indirect evidence (59%), 13 by indirect evidence (27%), and 7 by direct evidence (14%). Both network and pairwise meta-analysis provided strong evidence against the null hypothesis for seven comparisons, but for an additional 10 comparisons only network meta-analysis provided strong evidence against the null hypothesis (P=0.002). The median time to strong evidence against the null hypothesis was 19 years with living network meta-analysis and 23 years with living pairwise meta-analysis (hazard ratio 2.78, 95% confidence interval 1.00 to 7.72, P=0.05). Studies directly comparing the treatments of interest continued to be published for eight comparisons after strong evidence had become evident in network meta-analysis.ConclusionsIn comparative effectiveness research, prospectively planned living network meta-analyses produced strong evidence against the null hypothesis more often and earlier than conventional, pairwise meta-analyses.

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Section: Discussionmentioning

confidence: 99%

Living network meta-analysis compared with pairwise meta-analysis in comparative effectiveness research: empirical study

Nikolakopoulou

Mavridis

Furukawa

et al. 2018

BMJ

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“…Prostate cancer is mostly diagnosed in geriatric populations (3) . As Saudi Arabia is developing in health care and screening advances, the number of cases of clinically diagnosed prostate cancer is expected to rise.…”

Section: Discussionmentioning

confidence: 99%

“…The benefits of this is controversial with the European Randomized Study of Screening for Prostate Cancer (1) finding a significant reduction of PCa mortality with PSA screening while the US-based Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (2) showed no beneficial reduction in mortality with PSA and DRE (1,2) . However, a living metaanalysis found a small beneficial reduction of mortality with adequate duration of screening (3) . The American Cancer Society recommends individual with high risk to develop PCa to receive information about the potential benefits, risks and uncertainties of prostate cancer screening by the age of 40 (4) .…”

Section: Introductionmentioning

confidence: 99%

Awareness of Prostate Cancer, Screening and Methods of Managements in a Hospital in Riyadh, Saudi Arabia

Almuhanna

Alsalman

Al-Beladi

et al. 2018

Egyptian Journal of Hospital Medicine

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Background: screening for prostate cancer (PCa) is surrounded by controversies regarding the benefits, risks and uncertainties of undergoing the screening. Current practices of prostate cancer involve measuring the level of PSA and digital rectal examination. This study aimed to measure the knowledge and awareness of undergoing a prostate cancer screening and the available treatment options amongst the participants. Method: a questionnaire-based quantitative cross-sectional study which focuses on determining the knowledge of prostate cancer screening and management in a hospital in Riyadh. Results: three hundred and twenty-three participants filled the surveys (100% males), more than 80% of all ages had heard about prostate cancer and that it is a disease of the male. A higher level of education is significantly associated with the level of awareness (P-value <0.001). More educated participants selected 40 years old as the appropriate age for PCa screening (P-value 0.009) and radiotherapy as the mode of treatment (P-value 0.01). 43.34% saw PCa as a cause of death and 41.4% saw it associated with smoking. Only 17.84% undergo continuous PCa screening most of them in 50-60 age group with "reassurance" as the main motivator. 37.8% of the participants did not know the symptoms of PCa and around 25% selected pain in micturition, difficult frequent micturition and bone pain as symptoms of PCa. Conclusion: although prostate cancer is known amongst the majority of the participants, only a minority of them has knowledge of the symptoms and undergoes regular screening.

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“…Although some studies have reported that PSA screening decreased mortality rates due to prostate cancer, no definite evidence is yet available showing that screening could reduce PCa-related deaths 10 . However, reducing the cutoff of PSA below 4 ng/mL has led to increases in detection rates of clinically insignificant cancers 11 .…”

Section: Discussionmentioning

confidence: 99%

Is Prostate Biopsy Recommended in Turkish Men with a Prostate-Specific Antigen Level between 2.5 and 4 ng/mL?

Koç¹,

Türk

Karabıçak³

et al. 2017

Current Therapeutic Research

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BackgroundProstate cancer is the most common solid tumor. The incidence of prostate cancer shows regional and racial differences. The ideal PSA threshold for prostate biopsy is still being debated.ObjectiveWe aimed to investigate cancer detection rates in Turkish men who underwent transrectal ultrasound-guided prostate biopsy (TRUSPB) who had prostate-specific antigen (PSA) levels in the range of 2.5 to 4.0 ng/mL and compare them with the rates of cancer in patients with PSA levels in the range of 4.0 to 10.0 ng/mL.MethodsAll Turkish men who underwent TRUSPB in our clinic between January 2012 and May 2014 were included; that is, 101 patients (Group 1) with PSA level in the range of 2.5 to 4.0 ng/mL and 522 patients (Group 2) with PSA level in the range of 4.0 to 10.0 ng/mL. Mean PSA level, age, prostate volume, and cancer detection rates were evaluated.ResultsThe mean age was 60.5 and 64 years in Group 1 and Group 2, respectively (P = 0.06). The mean PSA level was determined as 3.1 and 6.8 ng/mL in Group 1 and Group 2, respectively (P = 0.03). The cancer detection rate was 12.7% in Group 1 (n = 13) and 30.8% in Group 2 (n = 161), which revealed a statistically significant difference between the 2 groups (P = 0.001). In Group 1, 9 of 13 patients (69%) had Gleason score of 6, 3 (23%) had Gleason score of 7, and 1 (8%) had a Gleason score of 8.ConclusionsThe cancer detection rate is lower in Turkish men with PSA level in the range of 2.5 to 4.0 ng/mL when compared with men with PSA level in the range of 4.0 to 10.0 ng/mL. Furthermore, most patients in whom cancer was detected who have a PSA level in the range of 2.5 to 4.0 ng/mL are low risk. Therefore, the benefit of TRUSBP in Turkish men with PSA level between 2.5 and 4 ng/mL is low.

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Screening Coverage Needed to Reduce Mortality from Prostate Cancer: A Living Systematic Review

Cited by 16 publications

References 33 publications

Living network meta-analysis compared with pairwise meta-analysis in comparative effectiveness research: empirical study

Living network meta-analysis compared with pairwise meta-analysis in comparative effectiveness research: empirical study

Awareness of Prostate Cancer, Screening and Methods of Managements in a Hospital in Riyadh, Saudi Arabia

Is Prostate Biopsy Recommended in Turkish Men with a Prostate-Specific Antigen Level between 2.5 and 4 ng/mL?

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