Is Prostate-Specific Antigen Effective for Population Screening of Prostate Cancer? A Systematic Review
Annals of Laboratory Medicine
;
: 233-241, 2013.
Artigo
em Inglês
| WPRIM
| ID: wpr-105292
ABSTRACT
BACKGROUND:
The effectiveness of prostate-specific antigen (PSA) for population screening has presented controversial results in large trials and prior reviews. We investigated the effectiveness of PSA population screening in a systematic review.METHODS:
The study was conducted using existing systematic reviews. We searched Ovid MEDLINE, Embase, Cochrane library, and the major Korean databases. The quality of the systematic reviews was assessed by two reviewers independently using AMSTAR. Randomized controlled trials were assessed using the risk of bias tool in the Cochrane group. Meta-analyses were conducted using Review Manager. The level of evidence of each outcome was assessed using GRADE.RESULTS:
Prostate-cancer-specific mortality was not reduced based on similar prior reviews (relative risk [RR] 0.93; 95% confidence interval [CI], 0.81-1.07, P=0.31). The detection rate of stage 1 prostate cancer was not greater, with a RR of 1.67 (95% CI, 0.95-2.94) and high heterogeneity. The detection rate of all cancer stages in the screening group was high, with a RR of 1.45 (95% CI, 1.13-1.85). No difference in all-cause mortality was observed between the screening and control groups (RR, 0.99; 95% CI, 0.98-1.01, P=0.50). Prostate-cancer-specific mortality, all-cause mortality, and diagnosis of prostate cancer at stages 3-4 showed moderate levels of evidence.CONCLUSIONS:
Differently from prior studies, our review included updated Norrkoping data and assessed the sole effect of PSA testing for prostate cancer screening. PSA screening alone did not increase early stage prostate cancer detection and did not lower mortality.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Neoplasias da Próstata
/
Programas de Rastreamento
/
Ensaios Clínicos como Assunto
/
Bases de Dados Factuais
/
Antígeno Prostático Específico
/
Estadiamento de Neoplasias
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo diagnóstico
/
Estudo de etiologia
/
Estudo prognóstico
/
Estudo de rastreamento
/
Revisões Sistemáticas Avaliadas
Limite:
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Annals of Laboratory Medicine
Ano de publicação:
2013
Tipo de documento:
Artigo
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