Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Practice Guideline
. 2013 Aug;190(2):419-26.
doi: 10.1016/j.juro.2013.04.119. Epub 2013 May 6.

Early detection of prostate cancer: AUA Guideline

H Ballentine Carter  1 , Peter C Albertsen, Michael J Barry, Ruth Etzioni, Stephen J Freedland, Kirsten Lynn Greene, Lars Holmberg, Philip Kantoff, Badrinath R Konety, Mohammad Hassan Murad, David F Penson, Anthony L Zietman
Affiliations
Practice Guideline

Early detection of prostate cancer: AUA Guideline

H Ballentine Carter et al. J Urol. 2013 Aug.

Abstract

Purpose: The guideline purpose is to provide the urologist with a framework for the early detection of prostate cancer in asymptomatic average risk men.

Materials and methods: A systematic review was conducted and summarized evidence derived from over 300 studies that addressed the predefined outcomes of interest (prostate cancer incidence/mortality, quality of life, diagnostic accuracy and harms of testing). In addition to the quality of evidence, the panel considered values and preferences expressed in a clinical setting (patient-physician dyad) rather than having a public health perspective. Guideline statements were organized by age group in years (age <40; 40 to 54; 55 to 69; ≥ 70).

Results: Except prostate specific antigen-based prostate cancer screening, there was minimal evidence to assess the outcomes of interest for other tests. The quality of evidence for the benefits of screening was moderate, and evidence for harm was high for men age 55 to 69 years. For men outside this age range, evidence was lacking for benefit, but the harms of screening, including over diagnosis and overtreatment, remained. Modeled data suggested that a screening interval of two years or more may be preferred to reduce the harms of screening.

Conclusions: The Panel recommended shared decision-making for men age 55 to 69 years considering PSA-based screening, a target age group for whom benefits may outweigh harms. Outside this age range, PSA-based screening as a routine could not be recommended based on the available evidence.

Keywords: DRE; ERSPC; European Randomized Study of Screening for Prostate Cancer; FDA; Food and Drug Administration; PLCO; PSA; Prostate Lung, Colorectal and Ovarian; RCT; digital rectal examination; early detection of cancer; prostate specific antigen; prostate-specific antigen; prostatic neoplasms; randomized controlled trial.

PubMed Disclaimer

Figures

Figur 1
Figur 1
Influence of evidence and interpretation on policy creation
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Gordis L. The Epidemiologic Approach to Evaluating Screening Programs. Epidemiology. (4th edition) 2009
    1. Faraday M, Hubbard H, Kosiak B, et al. Staying at the cutting edge: a review and analysis of evidence reporting and grading; the recommendations of the American Urological Association. BJU Int. 2009;104:294. - PubMed
    1. Andriole GL, Grubb RL, Buys SS, et al. Mortality results from a randomized prostate-cancer screening trial. N Engl J Med. 2009;360:1310. - PMC - PubMed
    1. Schroder FH, Hugosson J, Roobol MJ, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009;360:1320. - PubMed
    1. Barry MJ, Edgman-Levitan S. Shared decision making--pinnacle of patient-centered care. N Engl J Med. 2012;366:780. - PubMed

Publication types

Substances