Screening for prostate cancer

Abstract

Given that only two randomised controlled trials were included, and the high risk of bias of both trials, there is insufficient evidence to either support or refute the routine use of mass, selective or opportunistic screening compared to no screening for reducing prostate cancer mortality. Currently, no robust evidence from randomised controlled trials is available regarding the impact of screening on quality of life, harms of screening, or its economic value. Results from two ongoing large scale multicentre randomised controlled trials that will be available in the next several years are required to make evidence-based decisions regarding prostate cancer screening.

Factors Related to Prostate-Specific Antigen–Based Prostate Cancer Screening in Primary Care: Retrospective Cohort Study of 120,587 French Men Over the Age of 50 Years (Preprint)

“…This finding is consistent with international guidelines and recommendations suggesting that life expectancy should be considered before recommending screening [8] [18]. However, some patients with major comorbidities, such as pulmonary, renal, or hepatic failure, were screened as frequently as was the general population.…”

Factors Related to Prostate-Specific Antigen–Based Prostate Cancer Screening in Primary Care: Retrospective Cohort Study of 120,587 French Men Over the Age of 50 Years (Preprint)

“…This finding is consistent with international guidelines and recommendations suggesting that life expectancy should be considered before recommending screening [8] [18]. However, some patients with major comorbidities, such as pulmonary, renal, or hepatic failure, were screened as frequently as was the general population.…”

Variation in general practice prostate-specific antigen testing and prostate cancer outcomes: An ecological study

“…27,29 The similarity in mortality (prostate cancer-specific and overall) in the four groups is in line with the findings by several studies and a recent Cochrane review on five screening trials. 2,21,22,24,30 However, this contrasts the findings from the ERSPC, which found a small decrease in prostate cancer-specific mortality in the screened group but not before 9 years of followup. 23 We cannot rule out that a longer follow-up could have resulted in a mortality difference in our study, but subanalysis on the 1,174 patients in our study diagnosed in 2004 and 2005 (median follow-up 6.0 years) also failed to show reductions in prostate cancer mortality, IRR 5 1.15 (0.88-1.50) in group 4.…”

Improving health profile of blood donors as a consequence of transfusion safety efforts

“…The greater deficit for cancer mortality compared to incidence points to possible screening effects. Notably, the decrease in cancer mortality across successive subcohorts defined by calendar year of first recorded donation, not accompanied by a corresponding decline in relative cancer incidence, represents a better prognosis in donors, which is consistent, albeit of smaller magnitude, with what is observed in screened populations 28,29 and may be due to better surveillance of this group.…”

Factors Related to Prostate-Specific Antigen–Based Prostate Cancer Screening in Primary Care: Retrospective Cohort Study of 120,587 French Men Over the Age of 50 Years (Preprint)

“…This finding is consistent with international guidelines and recommendations suggesting that life expectancy should be considered before recommending screening [8] [18]. However, some patients with major comorbidities, such as pulmonary, renal, or hepatic failure, were screened as frequently as was the general population.…”

Variation in general practice prostate-specific antigen testing and prostate cancer outcomes: An ecological study

“…27,29 The similarity in mortality (prostate cancer-specific and overall) in the four groups is in line with the findings by several studies and a recent Cochrane review on five screening trials. 2,21,22,24,30 However, this contrasts the findings from the ERSPC, which found a small decrease in prostate cancer-specific mortality in the screened group but not before 9 years of followup. 23 We cannot rule out that a longer follow-up could have resulted in a mortality difference in our study, but subanalysis on the 1,174 patients in our study diagnosed in 2004 and 2005 (median follow-up 6.0 years) also failed to show reductions in prostate cancer mortality, IRR 5 1.15 (0.88-1.50) in group 4.…”

Improving health profile of blood donors as a consequence of transfusion safety efforts

“…The greater deficit for cancer mortality compared to incidence points to possible screening effects. Notably, the decrease in cancer mortality across successive subcohorts defined by calendar year of first recorded donation, not accompanied by a corresponding decline in relative cancer incidence, represents a better prognosis in donors, which is consistent, albeit of smaller magnitude, with what is observed in screened populations 28,29 and may be due to better surveillance of this group.…”

Factors Related to Prostate-Specific Antigen–Based Prostate Cancer Screening in Primary Care: Retrospective Cohort Study of 120,587 French Men Over the Age of 50 Years (Preprint)

“…This finding is consistent with international guidelines and recommendations suggesting that life expectancy should be considered before recommending screening [8] [18]. However, some patients with major comorbidities, such as pulmonary, renal, or hepatic failure, were screened as frequently as was the general population.…”

Variation in general practice prostate-specific antigen testing and prostate cancer outcomes: An ecological study

“…27,29 The similarity in mortality (prostate cancer-specific and overall) in the four groups is in line with the findings by several studies and a recent Cochrane review on five screening trials. 2,21,22,24,30 However, this contrasts the findings from the ERSPC, which found a small decrease in prostate cancer-specific mortality in the screened group but not before 9 years of followup. 23 We cannot rule out that a longer follow-up could have resulted in a mortality difference in our study, but subanalysis on the 1,174 patients in our study diagnosed in 2004 and 2005 (median follow-up 6.0 years) also failed to show reductions in prostate cancer mortality, IRR 5 1.15 (0.88-1.50) in group 4.…”

Improving health profile of blood donors as a consequence of transfusion safety efforts

“…The greater deficit for cancer mortality compared to incidence points to possible screening effects. Notably, the decrease in cancer mortality across successive subcohorts defined by calendar year of first recorded donation, not accompanied by a corresponding decline in relative cancer incidence, represents a better prognosis in donors, which is consistent, albeit of smaller magnitude, with what is observed in screened populations 28,29 and may be due to better surveillance of this group.…”