Global InformationProstate cancer screening information
| Prostate cancer screening | |
|---|---|
| Purpose | Detect prostate cancer (when no symptoms are present) |
Prostate cancer screening is the screening process used to detect undiagnosed prostate cancer in men without signs or symptoms.[1][2] When abnormal prostate tissue or cancer is found early, it may be easier to treat and cure, but it is unclear if early detection reduces mortality rates.[2]
Screening precedes a diagnosis and subsequent treatment. The digital rectal examination (DRE) is one screening tool, during which the prostate is manually assessed through the wall of the rectum. The second screening tool is the measurement of prostate-specific antigen (PSA) in the blood. The evidence remains insufficient to determine whether screening with PSA or DRE reduces mortality from prostate cancer.[1] A 2013 Cochrane review concluded PSA screening results in "no statistically significant difference in prostate cancer-specific mortality...".[3] The American studies were determined to have a high bias. European studies included in this review were of low bias and one reported "a significant reduction in prostate cancer-specific mortality." PSA screening with DRE was not assessed in this review. DRE was not assessed separately.[3]
Most recent guidelines have recommended that the decision whether or not to screen should be based on shared decision-making,[4] so that men are informed of the risks and benefits of screening.[5][6] In 2012, the American Society of Clinical Oncology recommends screening be discouraged for those who are expected to live less than ten years, while for those with a longer life expectancy a decision should be made by the person in question. In general, they conclude that based on recent research, "it is uncertain whether the benefits associated with PSA testing for prostate cancer screening are worth the harms associated with screening and subsequent unnecessary treatment."[7]
Prostate biopsies are used to diagnose prostate cancer but are not done on asymptomatic men and therefore are not used for screening.[8][9] Infection after prostate biopsy occurs in about 1%, while death occurs as a result of biopsy in 0.2%.[10][11] Prostate biopsy guided by magnetic resonance imaging has improved the diagnostic accuracy of the procedure.[12][13]
- ^ a b PDQ Screening and Prevention Editorial Board (2018). "Prostate Cancer Screening (PDQ®): Health Professional Version". PDQ Cancer Information Summaries. Bethesda (MD): National Cancer Institute (US). PMID 26389383.
This article incorporates text from this source, which is in the public domain.
- ^ a b "Prostate Cancer Screening-Professional Version". National Cancer Institute. 1980-01-01. Retrieved 2018-02-28. This article incorporates text from this source, which is in the public domain.
- ^ a b Cite error: The named reference
:7was invoked but never defined (see the help page). - ^ "Prostate Cancer Guidelines". Emedicine. 2017. Retrieved 18 February 2018.
- ^ Greene KL, Albertsen PC, Babaian RJ, Carter HB, Gann PH, Han M, et al. (January 2013). "Prostate specific antigen best practice statement: 2009 update". The Journal of Urology. 189 (1 Suppl): S2–S11. doi:10.1016/j.juro.2012.11.014. PMID 23234625.
- ^ Wolf AM, Wender RC, Etzioni RB, Thompson IM, D'Amico AV, Volk RJ, et al. (Mar–Apr 2010). "American Cancer Society guideline for the early detection of prostate cancer: update 2010". CA: A Cancer Journal for Clinicians. 60 (2): 70–98. doi:10.3322/caac.20066. PMID 20200110. S2CID 21548482.
- ^ Basch E, Oliver TK, Vickers A, Thompson I, Kantoff P, Parnes H, et al. (August 2012). "Screening for prostate cancer with prostate-specific antigen testing: American Society of Clinical Oncology Provisional Clinical Opinion". Journal of Clinical Oncology. 30 (24): 3020–5. doi:10.1200/JCO.2012.43.3441. PMC 3776923. PMID 22802323.
- ^ Borghesi M, Ahmed H, Nam R, Schaeffer E, Schiavina R, Taneja S, et al. (March 2017). "Complications After Systematic, Random, and Image-guided Prostate Biopsy". European Urology. 71 (3): 353–365. doi:10.1016/j.eururo.2016.08.004. hdl:11585/559951. PMID 27543165.
- ^ Loeb S, Vellekoop A, Ahmed HU, Catto J, Emberton M, Nam R, et al. (December 2013). "Systematic review of complications of prostate biopsy". European Urology. 64 (6): 876–92. doi:10.1016/j.eururo.2013.05.049. PMID 23787356.
- ^ Bennett HY, Roberts MJ, Doi SA, Gardiner RA (June 2016). "The global burden of major infectious complications following prostate biopsy". Epidemiology and Infection. 144 (8): 1784–91. doi:10.1017/S0950268815002885. PMC 9150640. PMID 26645476. S2CID 82280.
- ^ Cite error: The named reference
CMAJ2014was invoked but never defined (see the help page). - ^ Schoots IG, Roobol MJ, Nieboer D, Bangma CH, Steyerberg EW, Hunink MG (September 2015). "Magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis". European Urology. 68 (3): 438–50. doi:10.1016/j.eururo.2014.11.037. PMID 25480312.
- ^ Wegelin O, van Melick HH, Hooft L, Bosch JL, Reitsma HB, Barentsz JO, et al. (April 2017). "Comparing Three Different Techniques for Magnetic Resonance Imaging-targeted Prostate Biopsies: A Systematic Review of In-bore versus Magnetic Resonance Imaging-transrectal Ultrasound fusion versus Cognitive Registration. Is There a Preferred Technique?". European Urology. 71 (4): 517–531. doi:10.1016/j.eururo.2016.07.041. PMID 27568655.
