screening 24 April 2020 Institute for Quality and Efficiency in Health Care (IQWiG) - 1 - 1 Background Prostate cancer 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, prostate cancer is the most common tumour disease 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 prostate cancer [1]. Age is considered the most important risk factor for the development of prostate cancer [1, 2]. At a median age of onset of 72 years, prostate cancer occurs predominantly in advanced age; it is rarely found before the 45 th to 50 th year of life [1]. Every year, about 14 000 men in Germany die of the consequences of prostate cancer [1]. The prognosis of the disease decisively depends on the tumour stage as well as tumour typing

A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer The European Randomized study of Screening for Prostate Cancer (ERSPC) has previously demonstrated that prostate-specific antigen (PSA) screening decreases prostate cancer (PCa) mortality.To determine whether PSA screening decreases PCa mortality for up to 16yr and to assess results following adjustment for nonparticipation and the number of screening rounds attended.This multicentre population-based randomised (...) significantly reduces PCa mortality, showing larger absolute benefit with longer follow-up and a reduction in excess incidence. Repeated screening may be important to reduce PCa mortality on a population level.In this report, we looked at the outcomes from prostate cancer in a large European population. We found that repeated screening reduces the risk of dying from prostate cancer.Copyright © 2019. Published by Elsevier B.V.

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 prostate cancer (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 prostate cancer screening 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 prostate tumors (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 prostate cancer (...) was similar in both NSAID users and nonusers. Screening decreased prostate cancer 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

, prostate biopsy, prostate cancer 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 prostate cancer : a rapid review Harms of Prostate -Specific Antigen ( PSA ) screening in prostate cancer : a rapid review Harms (...) Prostate cancer screening Top results for prostate cancer 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

Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement. In the United States, the lifetime risk of being diagnosed with prostate cancer is approximately 13%, and the lifetime risk of dying of prostate cancer is 2.5%. The median age of death from prostate cancer is 80 years. Many men with prostate cancer never experience symptoms and, without screening, would never know they have the disease. African American men and men with a family history of prostate cancer (...) have an increased risk of prostate cancer 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 prostate cancer and subsequent treatment of screen-detected prostate cancer. The USPSTF also commissioned a review of existing decision analysis models and the overdiagnosis rate of PSA-based screening

Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial. Prostate cancer screening 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 prostate cancer-specific mortality.The Cluster Randomized Trial of PSA Testing (...) stage and Gleason grade (range, 2-10; higher scores indicate a poorer prognosis) of prostate cancers 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 prostate cancer: development and validation in large scale cohorts. To develop and validate a genetic tool to predict age of onset of aggressive prostate cancer (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 prostate cancer screening but also for consideration of treatment options. Once diagnosed with prostate cancer, 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 prostate cancer 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 Prostate Cancer (ERSPC), which suggests that screening may reduce the long term risk of prostate cancer-specific mortality by at least 9% (relative reduction). They also note (...) that substantial observational evidence indicates a reduction in advanced disease and reduction in prostate cancer mortality, which they attribute to the introduction of PSA screening. Opponents of PSA screening highlight the indolent natural course of prostate cancer, citing systematic reviews that reported little or no impact of PSA screening on overall and prostate cancer-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 prostate cancer is approximately 11%, and the lifetime risk of dying of prostate cancer is 2.5%. Many men with prostate cancer 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 prostate cancer. 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 prostate cancer 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, prostate cancer

Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials. The ERSPC (European Randomized Study of Screening for Prostate Cancer) found that screening reduced prostate cancer mortality, but the PLCO (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial) found no reduction.To evaluate whether effects of screening on prostate cancer mortality relative to no screening differed between the ERSPC and PLCO.Cox regression of prostate cancer 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; prostate cancer incidence

Impact of Prostatic-specific Antigen Threshold and Screening Interval in Prostate Cancer Screening Outcomes: Comparing the Swedish and Finnish European Randomised Study of Screening for Prostate Cancer Centres. The European Randomised Study of Screening for Prostate Cancer trial has shown a 21% reduction in prostate cancer (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 Prostate Cancer Screening 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 (...) Prostate Cancer Screening 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

Prostate cancer screening

Prostate cancer screening and early diagnosis Canadian Urological Association recommendations on prostate cancer screening and early diagnosis To view this page ensure that Adobe Flash Player version 10.0.0 or greater is installed. Besides, it's possible to , or you can view flippdf Either scripts and active content are not permitted to run or Adobe Flash Player version 10.0.0 or greater is not installed. Besides, it's possible to , or you can view flippdf

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. 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 prostate cancer (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 Prostate Cancer Screening Behaviors Among Men Over 50 Years of Age in Hamadan: Perceived Threat and Efficacy Prostate cancer 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 prostate cancer screening 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, prostate cancer screening behaviors and psychological factors related to prostate cancer. 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

Prostate Cancer Incidence and PSA Testing Patterns in Relation to USPSTF Screening Recommendations. Prostate cancer incidence in men 75 years and older substantially decreased following the 2008 US Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen (PSA)-based screening for this age group. It is unknown whether incidence has changed since the USPSTF recommendation against screening for all men in May 2012.To examine recent changes in stage-specific prostate (...) cancer incidence and PSA screening rates following the 2008 and 2012 USPSTF recommendations.Ecologic study of age-standardized prostate cancer incidence (newly diagnosed cases/100,000 men aged ≥50 years) by stage from 2005 through 2012 using data from 18 population-based Surveillance, Epidemiology, and End Results (SEER) registries and PSA screening rate in the past year among men 50 years and older without a history of prostate cancer who responded to the 2005 (n = 4580), 2008 (n = 3476), 2010 (n

Subject indexing assigned by CRD MeSH Cost-Benefit Analysis; Early Detection of Cancers; Male; Mass Screening; Prostate-Specific Antigen; Prostatic Neoplasms Language Published English Country of organisation Canada Province or state Ontario English summary An English language summary is available. Address for correspondence Evidence Development and Standards, Health Quality Ontario, 130 Bloor Street West, 10th floor, Toronto, Ontario Canada M5S 1N5 Email: EDSinfo@hqontario.ca AccessionNumber (...) Prostate-Specific Antigen (PSA)?based population screening for prostate cancer: an economic analysis Prostate-Specific Antigen (PSA)–based population screening for prostate cancer: an economic analysis Prostate-Specific Antigen (PSA)–based population screening for prostate cancer: an economic analysis Tawfik A 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