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Is this the End of Prostate Cancer Screening?

german translation / full article

Andreas Sönnichsen

Question

About one year ago the U.S. Preventive Services Taskforce published a clear recommendation against prostate cancer screening. Now the American College of Physicians also published a clear recommendation against the screening. Should prostate cancer screening completely be omitted in daily practice?

Answer

The U.S. Preventive Services Taskforce (USPSTF) as well as the American College of Physicians recommend against both a populationwide or opportunistic screening for prostate cancer. Data from several randomized controlled trials have been put together in a meta-analysis of a recently published Cochrane review. The evaluation shows clearly that (if at all) a marginal benefit regarding prostate cancer mortality could be achieved which is shown in only one of the screening RCTs. This marginal benefit, however, is accompanied by significant harm caused by overdiagnosis and invasive treatment like prostatectomy and radiation which outweighs the benefit by far. The ACP weakens its recommendation by stating that screening can be considered in patients at elevated risk for prostate cancer and those explicitly asking for the screening after thorough information regarding the negative risk/benefit ratio.


(State: 14.05.2013)

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