PROSTATE CANCER SCREENING: SYSTEMATIC LITERATURE REVIEW OF WORLDWIDE PERSPECTIVES
DOI:
https://doi.org/10.13037/ras.vol16n55.4707Keywords:
Prostate, neoplasia, screening, PSA, digital rectal examinationAbstract
Introduction: Over the last decade increased the debate regarding prostate cancer screening and one of the main discussed topics were: when, in whom, and how to use PSA levels and/or DRE in a population based level. Once different institutions, government and RCT’s provide distinct, and sometimes, controversial recommendations, an attempt to summarize these studies is valuable. Aim: The study aimed to assess the actual state of the art of recommendations regarding the use of routine mass, selective, or opportunistic screening for prostate cancer with PSA levels and/or DRE. Material and methods: A narrative review of the literature was undertaken through MEDLINE, LILACS, Embase and Cochrane Library database, using pre-established search terms at University of Santo Amaro (Unisa), São Paulo, Brazil. Initial selection was performed based on title and abstracts assessment. Full-text analysis and critical appraisal of large, prospective RCT, comprehensive meta-analysis, National Taskforces, Medical and National organizations recommendations were accomplished. Results: Search strategy yielded 1046 citations. Thirteen recommendations had their levels of evidence and points of divergence or agreement evaluated. Conclusion: Existing RCT’s exhibit insufficient levels of agreement and additionally governmental guidelines are based on them. Some worldwide recommendations are currently summarized in opposite extremes. Until high grade of recommendation studies determine the best methodology and group of population that would benefit from screening, the shared decision-making in well-informed individuals currently seems to be an appropriated recommendation regarding the population screening of prostate cancer and, by now, it seems reasonable to forgo mass screening as a public heatlh policy.
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