Early Detection of Prostate Cancer: AUA Guideline
Top Cited Papers
- 1 August 2013
- journal article
- practice guideline
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 190 (2), 419-426
- https://doi.org/10.1016/j.juro.2013.04.119
Abstract
Purpose: The guideline purpose is to provide the urologist with a framework for the early detection of prostate cancer in asymptomatic average risk men. Materials and Methods: A systematic review was conducted and summarized evidence derived from over 300 studies that addressed the predefined outcomes of interest (prostate cancer incidence/mortality, quality of life, diagnostic accuracy and harms of testing). In addition to the quality of evidence, the panel considered values and preferences expressed in a clinical setting (patient-physician dyad) rather than having a public health perspective. Guideline statements were organized by age group in years (age <40; 40 to 54; 55 to 69; ≥70). Results: Except prostate specific antigen-based prostate cancer screening, there was minimal evidence to assess the outcomes of interest for other tests. The quality of evidence for the benefits of screening was moderate, and evidence for harm was high for men age 55 to 69 years. For men outside this age range, evidence was lacking for benefit, but the harms of screening, including over diagnosis and overtreatment, remained. Modeled data suggested that a screening interval of two years or more may be preferred to reduce the harms of screening. Conclusions: The Panel recommended shared decision-making for men age 55 to 69 years considering PSA-based screening, a target age group for whom benefits may outweigh harms. Outside this age range, PSA-based screening as a routine could not be recommended based on the available evidence. The entire guideline is available at www.AUAnet.org/education/guidelines/prostate-cancer-detection.cfm.Keywords
This publication has 23 references indexed in Scilit:
- Recent Trends in Prostate Cancer Incidence by Age, Cancer Stage, and Grade, the United States, 2001–2007Prostate Cancer, 2012
- Prostate-Cancer Mortality at 11 Years of Follow-upThe New England Journal of Medicine, 2012
- Towards an Optimal Interval for Prostate Cancer ScreeningEuropean Urology, 2012
- Impact of Comorbidity on Survival Among Men With Localized Prostate CancerJournal of Clinical Oncology, 2011
- Screening for prostate cancer: an updated Cochrane systematic reviewBJU International, 2011
- A Model of Prostate-Specific Antigen Screening Outcomes for Low- to High-Risk MenArchives of Internal Medicine, 2009
- Prostate Specific Antigen Testing Among the Elderly—When To Stop?Journal of Urology, 2009
- Mortality Results from a Randomized Prostate-Cancer Screening TrialThe New England Journal of Medicine, 2009
- Individualized Screening Interval for Prostate Cancer Based on Prostate-Specific Antigen LevelArchives of Internal Medicine, 2005
- High grade prostatic intraepithelial neoplasia (HGPIN) and prostatic adenocarcinoma between the ages of 20-69: an autopsy study of 249 cases.1994