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Screening for prostate cancer in U.S. men ACPM position statement on preventive practice.
Am J Prev Med 2008; 34(2):164-70AJ

Abstract

INTRODUCTION

Prostate cancer is the leading cancer in U.S. men, and the third leading cause of cancer deaths. Principal screening tests for detection of asymptomatic prostate cancer include digital rectal examination (DRE) and measurement of the serum tumor marker, prostate-specific antigen (PSA). There are risks and benefits associated with prostate cancer screening. Randomized controlled trials of screening by DRE and PSA are limited to two previously published studies. Two other large-scale randomized controlled trials are currently in progress.

METHODS

This study reviewed the efficacy of DRE and PSA for prostate cancer screening found in the medical literature prior to July 2007.

RESULTS

Applications of PSA screening tests used in clinical practice include (1) a PSA cutoff of 4 ng/ml, (2) age-specific PSA, (3) PSA velocity, (4) PSA density, and (5) percent free PSA. Prostate cancer screening can detect early disease and offers the potential to decrease morbidity and mortality. Prostate cancer screening benefits, however, remain unproven, pending results of ongoing trials. There is currently no convincing evidence that early screening, detection, and treatment improves mortality. Limitations of prostate cancer screening include potential adverse health effects associated with false-positive and negative results, and treatment side effects.

CONCLUSIONS

The American College of Preventive Medicine concludes that there is insufficient evidence to recommend routine population screening with DRE or PSA. Clinicians caring for men, especially African-American men and those with positive family histories, should provide information about potential benefits and risks of prostate cancer screening, and the limitations of current evidence for screening, in order to maximize informed decision making.

Authors+Show Affiliations

Department of Internal Medicine, Griffin Hospital, Derby, Connecticut, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18201648

Citation

Lim, Lionel S., et al. "Screening for Prostate Cancer in U.S. Men ACPM Position Statement On Preventive Practice." American Journal of Preventive Medicine, vol. 34, no. 2, 2008, pp. 164-70.
Lim LS, Sherin K, ACPM Prevention Practice Committee. Screening for prostate cancer in U.S. men ACPM position statement on preventive practice. Am J Prev Med. 2008;34(2):164-70.
Lim, L. S., & Sherin, K. (2008). Screening for prostate cancer in U.S. men ACPM position statement on preventive practice. American Journal of Preventive Medicine, 34(2), pp. 164-70. doi:10.1016/j.amepre.2007.10.003.
Lim LS, Sherin K, ACPM Prevention Practice Committee. Screening for Prostate Cancer in U.S. Men ACPM Position Statement On Preventive Practice. Am J Prev Med. 2008;34(2):164-70. PubMed PMID: 18201648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Screening for prostate cancer in U.S. men ACPM position statement on preventive practice. AU - Lim,Lionel S, AU - Sherin,Kevin, AU - ,, PY - 2007/05/02/received PY - 2007/08/17/revised PY - 2007/10/02/accepted PY - 2008/1/19/pubmed PY - 2008/4/1/medline PY - 2008/1/19/entrez SP - 164 EP - 70 JF - American journal of preventive medicine JO - Am J Prev Med VL - 34 IS - 2 N2 - INTRODUCTION: Prostate cancer is the leading cancer in U.S. men, and the third leading cause of cancer deaths. Principal screening tests for detection of asymptomatic prostate cancer include digital rectal examination (DRE) and measurement of the serum tumor marker, prostate-specific antigen (PSA). There are risks and benefits associated with prostate cancer screening. Randomized controlled trials of screening by DRE and PSA are limited to two previously published studies. Two other large-scale randomized controlled trials are currently in progress. METHODS: This study reviewed the efficacy of DRE and PSA for prostate cancer screening found in the medical literature prior to July 2007. RESULTS: Applications of PSA screening tests used in clinical practice include (1) a PSA cutoff of 4 ng/ml, (2) age-specific PSA, (3) PSA velocity, (4) PSA density, and (5) percent free PSA. Prostate cancer screening can detect early disease and offers the potential to decrease morbidity and mortality. Prostate cancer screening benefits, however, remain unproven, pending results of ongoing trials. There is currently no convincing evidence that early screening, detection, and treatment improves mortality. Limitations of prostate cancer screening include potential adverse health effects associated with false-positive and negative results, and treatment side effects. CONCLUSIONS: The American College of Preventive Medicine concludes that there is insufficient evidence to recommend routine population screening with DRE or PSA. Clinicians caring for men, especially African-American men and those with positive family histories, should provide information about potential benefits and risks of prostate cancer screening, and the limitations of current evidence for screening, in order to maximize informed decision making. SN - 0749-3797 UR - https://www.unboundmedicine.com/medline/citation/18201648/Screening_for_prostate_cancer_in_U_S__men_ACPM_position_statement_on_preventive_practice_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(07)00687-3 DB - PRIME DP - Unbound Medicine ER -