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Review
. 2013 Jan 29:346:f325.
doi: 10.1136/bmj.f325.

Prostate cancer screening and the management of clinically localized disease

Timothy J Wilt  1 , Hashim U Ahmed
Affiliations
Review

Prostate cancer screening and the management of clinically localized disease

Timothy J Wilt et al. BMJ. .
No abstract available

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: HUA is co-principal investigator in several investigator led diagnostic and focal therapy trials in prostate cancer supported by the MRC (UK), National Institute for Health Research Health Technology Assessment programme, Pelican Cancer Foundation charity, and Prostate Cancer UK charity; HUA receives funding from USHIFU and Advanced Medical Diagnostics for clinical trials; HUA has received consultancy payments in the past from Steba Biotech and Oncura/GE Healthcare and payment for conference travel from USHIFU; TJW is a volunteer member of the US Preventive Services Task Force and chairman of the Prostate cancer Intervention Versus Observation Trial (PIVOT).

Figures

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Fig 1 Impact of age on the proportion of men found to have an abnormal serum prostate specific antigen concentration depending on threshold used. The bars represent the 10 year risk of a prostate cancer related death in each age group
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Fig 2 Forest plot showing the risk ratio with 95% confidence intervals from the two (of five) randomized prostate cancer screening trials judged to be at least “fair methodological quality” and of “low risk of bias” (PLCO and ERSPC). The vertical line represents no benefit
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Fig 3 Benefits and harms of screening men aged 55-69 years* with a prostate specific antigen (PSA) test every 1-4 years for 10 years. Calculations rely on assumptions and are imprecise. Estimates should be considered in the full context of clinical decision making and used to stimulate shared decision making
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Fig 4 Kaplan-Meier curves showing death from any cause and death from prostate cancer in the Prostate Cancer Intervention versus Observation Trial (PIVOT) comparing radical prostatectomy with observation
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Fig 5 Forest plots demonstrating subgroup effects (hazard ratio with 95% confidence intervals and P value for interaction) in the Prostate Cancer Intervention versus Observation Trial (PIVOT) comparing radical prostatectomy with observation. The vertical line indicates no effect. The size of the boxes indicates the weight of the effects
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References

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