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. 2015 Jan;61(1):e26-35.

Systematic review of clinical features of suspected prostate cancer in primary care

Sheila-Mae Young, Praveen Bansal, Emily T Vella, Antonio Finelli, Cheryl Levitt, Andrew Loblaw

Systematic review of clinical features of suspected prostate cancer in primary care

Sheila-Mae Young et al. Can Fam Physician. 2015 Jan.

Abstract
in English, French

Objective: To systematically review the literature and provide an update and integration of existing peer-reviewed guidelines with recent systematic reviews and with primary studies related to the early recognition and management of prostate cancer in primary care.

Data sources: We searched MEDLINE and EMBASE for relevant articles. The quality of the evidence to support existing guideline recommendations and the consistency of recommendations with updated evidence were assessed. Applicability in a Canadian primary care setting was also evaluated.

Study selection: All studies conducted in the primary care setting that provided information on clinical features predictive of prostate cancer were included. Also, studies that assessed the accuracy of nomograms to predict prostate cancer were reviewed.

Synthesis: The findings suggest that lower urinary tract symptoms are not highly predictive of prostate cancer. However, evidence suggests that FPs might be good at discriminating between patients with and without prostate cancer using digital rectal examination and prostate-specific antigen testing. Nomograms might also be useful in assessing patients for aggressive prostate cancers.

Conclusion: The results of this review can be used to inform recommendations for referral for suspected prostate cancer in the primary care setting. They could also inform development of prostate cancer diagnostic assessment programs.

Objectif: Faire une revue systématique de la littérature à propos des plus récentes directives vérifiées par des pairs et de leur application, et ce, à l’aide de revues systématiques récentes et d’études portant sur la détection précoce et sur le traitement du cancer de la prostate en contexte de soins primaires.

Sources des données: On a consulté MEDLINE et EMBASE à la recherche d’articles pertinents. La qualité des preuves à l’appui des directives existantes et leur cohérence avec les données les plus récentes ont été évaluées. On a également vérifié leur applicabilité dans un milieu de soins primaires au Canada.

Choix des études: On a retenu toutes les études effectuées en contexte de soins primaires qui contenaient des informations sur les caractéristiques cliniques prédictives de cancer prostatique. Ont aussi été examinées les études qui évaluaient la précision des nomogrammes comme facteur prédictif d’un cancer prostatique.

Synthèse: Ces résultats suggèrent que les symptômes du tractus urinaire distal ne constituent pas de très bons prédicteurs du cancer de la prostate. Les données suggèrent toutefois que les MF pourraient être habiles pour distinguer les patients souffrant ou non de cancer grâce au toucher rectal et au dosage de l’antigène prostatique spécifique. Des nomogrammes pourraient également être utiles pour évaluer les patients qui ont un cancer prostatique agressif.

Conclusion: Les résultats de cette revue peuvent servir à indiquer aux soignants de première ligne les cas où un patient qu’on suspecte d’avoir un cancer prostatique doit être dirigé en spécialité. Ils pourraient aussi susciter le développement de programmes d’évaluation du diagnostic du cancer de la prostate.

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Figures

Figure 1
Figure 1
Results of literature search strategies NICE—National Institute for Health and Care Excellence, NZGG—New Zealand Guidelines Group.
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