Prostate cancer screening: what we know and what we need to know.

Abstract:

OBJECTIVE:To critically evaluate the evidence for recommending the screening of asymptomatic men for prostate cancer with a blood test to detect a prostate-specific antigen (PSA). DATA SOURCES:Relevant articles on screening for prostate cancer were identified from MEDLINE searches, from the authors' files, and from the bibliographies of identified articles. STUDY SELECTION:In the absence of controlled prospective trials, the studies are primarily retrospective and contain information about the sensitivity, specificity, and predictive values of tests used to screen for prostate cancer; the natural history of untreated prostate cancer; the morbidity, mortality, and costs of definitive treatment; and reviews of screening study biases. DATA EXTRACTION:Potential treatment-related mortality and costs that could be incurred by screening were estimated using defined assumptions. RESULTS:Although screening for prostate cancer has the potential to save lives, because of possible overdiagnosis, screening and subsequent therapy could actually have a net unfavorable effect on mortality or quality of life or both. Given the performance characteristics of the test, widespread screening efforts would probably cost billions of dollars. CONCLUSIONS:The net benefit from widespread screening is unclear. A randomized prospective study of the effect of screening on prostate cancer mortality has therefore been initiated by the National Cancer Institute.

journal_name

Ann Intern Med

authors

Kramer BS,Brown ML,Prorok PC,Potosky AL,Gohagan JK

doi

10.7326/0003-4819-119-9-199311010-00009

subject

Has Abstract

pub_date

1993-11-01 00:00:00

pages

914-23

issue

9

eissn

0003-4819

issn

1539-3704

journal_volume

119

pub_type

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