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Screening for Prostate Cancer: Early Detection or Overdetection?

Vickers, Andrew J.; Roobol, Monique J. and Lilja, Hans LU (2012) In Annual Review of Medicine 63. p.161-170
Abstract
A sophisticated reading of the randomized trial evidence suggests that, although screening for prostate cancer with prostate-specific antigen (PSA) can reduce cancer-specific mortality, it does so at considerable cost in terms of the number of men who need to be screened, biopsied, and treated to prevent one death. The challenge is to design screening programs that maximize benefits (reducing prostate cancer mortality) and minimize costs (overtreatment). Recent research has suggested that this can be achieved by risk-stratifying screening and biopsy; increasing reliance on active surveillance for low-risk cancer; restricting radical prostatectomy to high-volume surgeons; and using appropriately high-dose radiotherapy. In current U. S.... (More)
A sophisticated reading of the randomized trial evidence suggests that, although screening for prostate cancer with prostate-specific antigen (PSA) can reduce cancer-specific mortality, it does so at considerable cost in terms of the number of men who need to be screened, biopsied, and treated to prevent one death. The challenge is to design screening programs that maximize benefits (reducing prostate cancer mortality) and minimize costs (overtreatment). Recent research has suggested that this can be achieved by risk-stratifying screening and biopsy; increasing reliance on active surveillance for low-risk cancer; restricting radical prostatectomy to high-volume surgeons; and using appropriately high-dose radiotherapy. In current U. S. practice, however, many men who are screened are unlikely to benefit, most men found to have low-risk cancers are referred for unnecessary curative treatment, and much treatment is given at low-volume centers. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
prostatic neoplasms, prostate-specific antigen (PSA), surgery, radiotherapy
in
Annual Review of Medicine
volume
63
pages
161 - 170
publisher
Annual Reviews
external identifiers
  • wos:000301838400010
  • scopus:84855953876
ISSN
0066-4219
DOI
10.1146/annurev-med-050710-134421
language
English
LU publication?
yes
id
36e1c075-0b62-4d41-9c13-5f94f53b893b (old id 2571462)
date added to LUP
2012-06-01 08:55:41
date last changed
2017-11-19 03:11:12
@article{36e1c075-0b62-4d41-9c13-5f94f53b893b,
  abstract     = {A sophisticated reading of the randomized trial evidence suggests that, although screening for prostate cancer with prostate-specific antigen (PSA) can reduce cancer-specific mortality, it does so at considerable cost in terms of the number of men who need to be screened, biopsied, and treated to prevent one death. The challenge is to design screening programs that maximize benefits (reducing prostate cancer mortality) and minimize costs (overtreatment). Recent research has suggested that this can be achieved by risk-stratifying screening and biopsy; increasing reliance on active surveillance for low-risk cancer; restricting radical prostatectomy to high-volume surgeons; and using appropriately high-dose radiotherapy. In current U. S. practice, however, many men who are screened are unlikely to benefit, most men found to have low-risk cancers are referred for unnecessary curative treatment, and much treatment is given at low-volume centers.},
  author       = {Vickers, Andrew J. and Roobol, Monique J. and Lilja, Hans},
  issn         = {0066-4219},
  keyword      = {prostatic neoplasms,prostate-specific antigen (PSA),surgery,radiotherapy},
  language     = {eng},
  pages        = {161--170},
  publisher    = {Annual Reviews},
  series       = {Annual Review of Medicine},
  title        = {Screening for Prostate Cancer: Early Detection or Overdetection?},
  url          = {http://dx.doi.org/10.1146/annurev-med-050710-134421},
  volume       = {63},
  year         = {2012},
}