Dragan Ilic1, Denise O'Connor, Sally Green, Timothy Wilt. 1. Monash Institute of Health Services Research, Monash Medical Centre, Monash University, Locked Bag 29, Clayton, VIC, 3168, Australia. dragan.ilic@med.monash.edu.au
Abstract
OBJECTIVES: The objective of this systematic review was to determine whether screening for prostate cancer reduces prostate cancer mortality. METHODS: A systematic search for randomised controlled trials was conducted through electronic scientific databases and a specialist register of the Cochrane Prostatic Diseases and Urologic Cancers Group. Manual searching of specific journals was also conducted. Two authors independently reviewed studies that met the inclusion criteria. Studies were independently assessed for quality. Data from included studies was also extracted independently. RESULTS: Two randomised controlled trials were included however, both trials had methodological weaknesses. Re-analysis of the reported data using intention-to-screen and meta-analysis indicated no statistically significant difference in prostate cancer mortality between men randomized for prostate cancer screening and controls (RR 1.01, 95% CI: 0.80-1.29). CONCLUSIONS: Given that only two randomised controlled trials were included, and the high risk of bias of both trials, there is insufficient evidence to either support or refute the routine use of screening compared to no screening for reducing prostate cancer mortality. Currently, no robust evidence from randomised controlled trials is available regarding the impact of screening on quality of life, harms of screening, or its economic value. Results from two ongoing large scale multi-center randomised controlled trials, which will be available in the upcoming few years, will assist patients and health professionals in making an evidence-based decision regarding the effectiveness of screening for prostate cancer.
OBJECTIVES: The objective of this systematic review was to determine whether screening for prostate cancer reduces prostate cancer mortality. METHODS: A systematic search for randomised controlled trials was conducted through electronic scientific databases and a specialist register of the Cochrane Prostatic Diseases and Urologic Cancers Group. Manual searching of specific journals was also conducted. Two authors independently reviewed studies that met the inclusion criteria. Studies were independently assessed for quality. Data from included studies was also extracted independently. RESULTS: Two randomised controlled trials were included however, both trials had methodological weaknesses. Re-analysis of the reported data using intention-to-screen and meta-analysis indicated no statistically significant difference in prostate cancer mortality between men randomized for prostate cancer screening and controls (RR 1.01, 95% CI: 0.80-1.29). CONCLUSIONS: Given that only two randomised controlled trials were included, and the high risk of bias of both trials, there is insufficient evidence to either support or refute the routine use of screening compared to no screening for reducing prostate cancer mortality. Currently, no robust evidence from randomised controlled trials is available regarding the impact of screening on quality of life, harms of screening, or its economic value. Results from two ongoing large scale multi-center randomised controlled trials, which will be available in the upcoming few years, will assist patients and health professionals in making an evidence-based decision regarding the effectiveness of screening for prostate cancer.
Authors: Jonas Hugosson; Sigrid Carlsson; Gunnar Aus; Svante Bergdahl; Ali Khatami; Pär Lodding; Carl-Gustaf Pihl; Johan Stranne; Erik Holmberg; Hans Lilja Journal: Lancet Oncol Date: 2010-07-02 Impact factor: 41.316
Authors: Eveline A M Heijnsdijk; Elisabeth M Wever; Anssi Auvinen; Jonas Hugosson; Stefano Ciatto; Vera Nelen; Maciej Kwiatkowski; Arnauld Villers; Alvaro Páez; Sue M Moss; Marco Zappa; Teuvo L J Tammela; Tuukka Mäkinen; Sigrid Carlsson; Ida J Korfage; Marie-Louise Essink-Bot; Suzie J Otto; Gerrit Draisma; Chris H Bangma; Monique J Roobol; Fritz H Schröder; Harry J de Koning Journal: N Engl J Med Date: 2012-08-16 Impact factor: 91.245