gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

What kind of changes did the publication of two large-scale RCTs lead to in prostate cancer screening guidelines ?

Meeting Abstract

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  • C. Hamashima - National Cancer Center of Japan, Tokyo, Japan

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP005

DOI: 10.3205/12gin117, URN: urn:nbn:de:0183-12gin1176

Veröffentlicht: 10. Juli 2012

© 2012 Hamashima.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Although prostate-specific antigen (PSA) screening is conducted worldwide, its effectiveness in reducing mortality from prostate cancer has remained controversial. In 2009, intermediate results from the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial were released. However, the results of the two studies were inconsistent. We investigated the assessment of the two RCT results in guidelines, evidence reports and statements.

Methods: A search was performed from March 2009 to December 2011 using MEDLINE, the G-I-N library, and the National Guidelines Clearinghouse to identify guidelines, evidence reports and statements that have evaluated the two RCTs. Additional reports recommended by experts were also included as needed. The changes in the revised guidelines, evidence reports and statements were compared.

Results: Six guidelines, two evidence reports and one statement matching our criteria were identified. Although most guidelines contained no change in basic recommendations for PSA screening, the USPTSF recommended against PSA screening for all age group.

Discussion: For the introduction of population-based screening, valid evidence is required based on long follow-up studies and the balance between benefits and harms should be considered. Most US reports pointed out the necessity of shared decision-making for PSA screening in clinical settings.

Implication for guideline developers: Even after the releases of two RCTs results, most reports have not revised their assessment of PSA screening. The effect of PSA screening is still controversial, and shared decision making is needed because the potential harms cannot be ignored.