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The potential problems associated with over-diagnosis and over-treatment that have been much debated in the world of prostate cancer over the past few years actually go well beyond prostate cancer.…
Objective To examine the evidence on the benefits and harms of screening for prostate cancer.
Design Systematic review and meta-analysis of randomised controlled trials.
Data sources Electronic databases including Medline, Embase, CENTRAL, abstract proceedings, and reference lists up to July 2010.
Review methods Included studies were randomised controlled trials comparing screening by prostate specific antigen with or without digital rectal examination versus no screening. Data abstraction and assessment of methodological quality with the GRADE approach was assessed by two independent reviewers and verified by the primary investigator. Mantel-Haenszel and inverse variance estimates were calculated and pooled under a random effects model expressing data as relative risks and 95% confidence intervals.
Results Six randomised controlled trials with a total of 387 286 participants that met inclusion criteria were analysed. Screening was associated with an increased probability of receiving a diagnosis of prostate cancer (relative risk 1.46, 95% confidence interval 1.21 to 1.77; P
A conversation between two extremely knowledgeable prostate cancer advocates in comments on an earlier post has highlighted the underlying problem of what we mean by “over-diagnosis” an…
Prostate cancer screening with the prostate-specific antigen (PSA) test or digital rectal exams has not been shown to reduce prostate cancer deaths. Get detailed information about prostate cancer screening, including potential benefits and harms, in this summary for clinicians.
Home to the journal Oncology, Cancer Network provides research and opinion on the screening, early detection, diagnosis, treatment, and prevention of cancers.