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Early detection of prostate cancer: AUA Guideline

Practice Guideline

Affiliations

• ¹ American Urological Association Education and Research, Inc., Linthicum, Maryland, USA.

• PMID: 23659877
• PMCID: PMC4020420
• DOI: 10.1016/j.juro.2013.04.119

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Practice Guideline

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

• ¹ American Urological Association Education and Research, Inc., Linthicum, Maryland, USA.

• PMID: 23659877
• PMCID: PMC4020420
• DOI: 10.1016/j.juro.2013.04.119

Item in Clipboard

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.

Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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Influence of evidence and interpretation…

Influence of evidence and interpretation on policy creation

Influence of evidence and interpretation on policy creation

• Early detection of prostate cancer continues to support rational, limited screening.

  Partin AW. Partin AW. J Urol. 2013 Aug;190(2):427-8. doi: 10.1016/j.juro.2013.05.030. Epub 2013 May 18. J Urol. 2013. PMID: 23688640 No abstract available.

• Re: Early detection of prostate cancer: AUA guideline: H. B. Carter, P. C. Albertsen, M. J. Barry, R. Etzioni, S. J. Freedland, K. L. Greene, L. Holmberg, P. Kantoff, B. R. Konety, M. H. Murad, D. F. Penson and A. L. Zietman J Urol 2013; 190: 419-426.

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• Words of wisdom. Re: Early detection of prostate cancer: AUA guideline.

  Linares Espinós E, Stephenson A. Linares Espinós E, et al. Eur Urol. 2013 Nov;64(5):857-8. doi: 10.1016/j.eururo.2013.08.041. Eur Urol. 2013. PMID: 24112614 No abstract available.

• Reply by authors.

  [No authors listed] [No authors listed] J Urol. 2013 Sep;190(3):1137-9. J Urol. 2013. PMID: 24137618 No abstract available.

• Words of wisdom. Re: Early detection of prostate cancer: AUA guideline.

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• American Urological Association (AUA) guideline on prostate cancer detection: process and rationale.

  Carter HB. Carter HB. BJU Int. 2013 Sep;112(5):543-7. doi: 10.1111/bju.12318. BJU Int. 2013. PMID: 23924423 Review.

• Screening for prostate cancer.

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• Screening for prostate cancer: a guidance statement from the Clinical Guidelines Committee of the American College of Physicians.

  Qaseem A, Barry MJ, Denberg TD, Owens DK, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Qaseem A, et al. Ann Intern Med. 2013 May 21;158(10):761-769. doi: 10.7326/0003-4819-158-10-201305210-00633. Ann Intern Med. 2013. PMID: 23567643

• Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement.

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• Screening for prostate cancer with the prostate-specific antigen test: a review of current evidence.

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• The use of PSA testing over more than 20 years: A population-based study in North-Eastern Italy.

  Taborelli M, Toffolutti F, Bidoli E, Dal Maso L, Del Zotto S, Clagnan E, Gobbato M, Serraino D, Franceschi S. Taborelli M, et al. Tumori. 2023 Aug;109(4):406-412. doi: 10.1177/03008916221128343. Epub 2022 Oct 10. Tumori. 2023. PMID: 36217669 Free PMC article.

• Prostate Cancer Knowledge, Beliefs and Screening Uptake among Black Survivors: A Qualitative Exploration at a Tertiary Hospital, Limpopo Province, South Africa.

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• Prostate cancer: the growing evidence supporting mid-life PSA testing.

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• Shared decision making for men facing prostate cancer treatment: a systematic review of randomized controlled trials.

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• Systematic review and meta-analysis of the diagnostic accuracy of prostate-specific antigen (PSA) for the detection of prostate cancer in symptomatic patients.

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