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Query: UMLS:C0600139 (Prostate Cancer)
 4,540 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The European Randomized Study of Screening for Prostate Cancer (ERSPC) is a large, randomized controlled trial of screening versus control, conducted in eight European countries (Belgium, Finland, France, Italy, the Netherlands, Spain, Sweden, and Switzerland). This article focuses on important aspects relating to recent findings from the ERSPC about two topics: first, leadtime and overdiagnosis, and second, prostate-specific antigen (PSA) as a test for repeated screening. The ERSPC together with the prostate cancer arm of the Prostate, Lung, Colon and Ovary (PLCO) screening trial of the National Cancer Institute in the United States are set to show or exclude an effect of screening on prostate cancer mortality. Both studies are progressing according to plan. Definitive endpoint-related data can be expected between 2005 and 2010 depending on the difference in prostate cancer mortality that may be shown between the screening and control arms. The ERSPC will allow a risk-to-benefit analysis including parameters of quality of life and cost. Overdiagnosis with present prostate cancer screening regimens is high. This amount of overdiagnosis is likely to be unacceptable for most healthcare policy makers and providers. Addressing overdiagnosis will be a major research task for urologists for the years to come. Present screening needs to be more "selective" for cases that have aggressive patterns and are likely to lead to clinical diagnosis of prostate cancer and/or death. The test characteristics of prostate-specific antigen (PSA) change after one use. The positive relation between PSA levels and positive predictive value (PPV) and detection rates in first screening rounds are lost. This may be compatible with the observation that tumor volumes in second round screening are smaller, and larger tumors are harvested. Tumor volume becomes a negative predictor in round 2, indicating that a large proportion of elevated PSA values are caused by benign prostatic hyperplasia (BPH) rather than by prostate cancer. While the outcome of the ongoing randomized studies is uncertain, screening tests cannot be refused to men who are well-informed and accept to take the risk of experiencing more harm than benefit as a result of a positive screening test result.
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PMID:Detection of prostate cancer: the impact of the European Randomized Study of Screening for Prostate Cancer (ERSPC). 1578 Jan 57

There continues to be controversy regarding serum Prostate-Specific Antigen (PSA) and prostate cancer screening. We anxiously await the results of two large prospective randomized clinical trials (Prostate, Lung, Colon, and Ovary-PCLO screening trial in the US and European Randomized Study of Screening for Prostate Cancer-ERSPC in Europe) assessing the benefits of prostate cancer screening. However the true question to answer may be which cancer to treat and when should we treat it.
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PMID:Prostate cancer--to screen, or not to screen, is that the question? 1910 47

This paper evaluates the use of prostate-specific antigen (PSA) as a screening tool for prostate cancer. A current and contentious issue in both public and medical spheres, we are still lacking clear evidence and guidelines. Here, the Wilson and Jungner screening criteria are used as a framework to suggest that PSA-testing is not yet a proven tool for population screening. Additionally, the conflicting results of two recent randomised controlled trials are compared. The European Randomised trial of Screening for Prostate Cancer (ERSPC) found that PSA screening reduced prostate cancer-related deaths by 20% (adjusted p=0.04). Meanwhile the North American Prostate, Lung, Colon and Ovarian cancer trial (PLCO) found no significant impact of screening on mortality. The reasons for these differing outcomes are discussed in greater detail under the categories of methodology, study size, screening interval, cause of death and tumour demographics. The authors of this article conclude that PSA screening, at best, has a moderate impact on prostate cancer mortality. PSA-screening does, however, pose a high risk of over-diagnosis and over-treatment with its associated morbidity. Furthermore, economic and quality of life evaluations are lacking at present. Data are awaited from the UK Department of Health - funded ProtecT study,as well as longer-term outcomes of the ERSPC.
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PMID:Prostate cancer: to screen or not to screen. 2170 13

Screening for prostate cancer by use of serum prostate specific antigen (PSA) remains controversial. In the recent Cochrane analysis, an attempt is made to clarify the issue by conducting a meta analysis of available randomized screening trials. Two large trials are considered to provide data of similar and sufficient quality to conduct a separate meta analysis. However, in the view of this author, this analysis fails because standard Cochrand quality criteria are not observed. Details are given and the outcome suggests that one of the trials, the European Randomized Study of Screening for Prostate Cancer (ERSPC) should be considered superior to the Prostate, Lung, Colon, Ovary screening trial (PLCO) conducted in the USA.
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PMID:ERSPC, PLCO studies and critique of cochrane review 2013. 2453 78