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Screening for prostate cancer: A Cochrane systematic review

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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

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Acknowledgments

We wish to thank Kristine Egberts for her help with this review. We would also like to thank the referees and editors of the Prostatic Diseases and Urologic Cancers Group for their comments and valuable assistance.

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Authors and Affiliations

  1. Monash Institute of Health Services Research, Monash Medical Centre, Monash University, Locked Bag 29, Clayton, VIC, 3168, Australia

    Dragan Ilic, Denise O’Connor & Sally Green

  2. Minneapolis VA Center for Chronic Disease Outcomes Research, Minneapolis, MN, 55417, USA

    Timothy Wilt

Authors
  1. Dragan Ilic
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  2. Denise O’Connor
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  3. Sally Green
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  4. Timothy Wilt
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Corresponding author

Correspondence to Dragan Ilic.

Additional information

This paper is based on a Cochrane review first published in The Cochrane Library 2006, Issue 3 (see www.thecochranelibrary.com for information). Cochrane reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and The Cochrane Library should be consulted for the most recent version of the review. The results of a Cochrane review can be interpreted differently, depending on people’s perspectives and circumstances. Please consider the conclusions presented carefully. They are the opinions of review authors, and are not necessarily shared by The Cochrane Collaboration

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Ilic, D., O’Connor, D., Green, S. et al. Screening for prostate cancer: A Cochrane systematic review. Cancer Causes Control 18, 279–285 (2007). https://doi.org/10.1007/s10552-006-0087-6

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  • DOI: https://doi.org/10.1007/s10552-006-0087-6

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