Systematic review of screening

23 June 2011

Cochrane Collaboration logoThe Cochrane Library has published an update to its review of the evidence on screening programmes for prostate cancer.

The review focuses on whether screening for prostate cancer:

  • reduces prostate cancer-specific mortality (the risk of dying from prostate cancer),
  • reduces all-cause mortality,
  • affects quality of life.

First published in 2006, the review has been updated to include the results of nwe randomised trials.  It now includes randomised trials with a total of 341 351 participants.  Note that the search was carried out in July 2010 so does not include any new research published since then.

Results

The reviewers combined the results of all trials and found that screening had no impact on overall survival or prostate cancer-specific mortality.  However, one large, high quality study reported a small but significant improvement in prostate cancer-specific mortality among men aged 55 to 70.  None of the trials reported the impact of screening on quality of life.

Harms of screening

The reviewers report the harms of screening as:

  • included high rates of false-positive results for the PSA test (up to 75.9%),
  • over-diagnosis (up to 50% in the ERSPC study)
  • adverse events associated with transrectal ultrasound (TRUS) guided biopsies such as infection, bleeding and pain.

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Page last edited: 02 October 2011