Evidence map›Paper›PMID 30185521›Full record

SynthesisBMJ (Clinical research ed.)2018

Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis.

Dragan Ilic, Mia Djulbegovic, Jae Hung Jung, Eu Chang Hwang, Qi Zhou, Anne Cleves, Thomas Agoritsas, Philipp Dahm

3 registry-linked trialsOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 332 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
332citing papers in PubMed, 11 pooled it
35.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05587192 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Radical Prostatectomy Without Prostate Biopsy Following 18F-PSMA-1007 PET/CT Based on a Diagnostic Model: a Single-center, Single-arm, Open-label Study

TypeinterventionalSponsorAnhui Provincial HospitalRan2022 to 2024Enrolled57ConditionsProstate CancerArms18F-PSMA-1007 PET/CT based on diagnostic model
NCT05940415 unknown statusnot on this mapstarted 2023, after this paper: background citation

Conducting Active Surveillance Without Prostate Biopsy for Patients With Low-risk Suspected Prostate Cancer Based on USTC Diagnostic Model and PSA Level: a Multicenter Prospective Study

TypeobservationalSponsorAnhui Provincial HospitalRan2023 to 2026Enrolled220ConditionsProstate CancerArmsactive surveillance
NCT06360523 narecruitingnot on this mapstarted 2024, after this paper: background citation

ProstateAI - A Prospective Paired Validating Cohort Study to Evaluate an MRI-based Optimized Prostate Cancer Diagnostic Pathway Powered by Artificial Intelligence

TypeinterventionalSponsorChinese University of Hong KongRan2024 to 2028Enrolled368ConditionsProstate CancerArmsAI modal, Standard review
3 · Its place in the literature

Who cites it

332 citing papers in PubMed, 11 syntheses or guidelines pooled it, 616 citations in OpenAlex.

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272 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 8 institutions in 6 countries.

Dragan IlicSchool of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
Mia DjulbegovicNational Clinicians Scholars Program, Yale University School of Medicine, and Veterans Affairs Connecticut Healthcare System, New Haven, Connecticut, USA.
Jae Hung JungDepartment of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Eu Chang HwangDepartment of Urology, Chonnam National University Medical School, Gwangju, Korea.
Qi ZhouDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Anne ClevesVelindre NHS Trust, Cardiff University Library Services, Velindre Cancer Centre, Cardiff, Wales.
Thomas AgoritsasDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Philipp DahmUrology Section, Minneapolis VAMC and Department of Urology, University of Minnesota, Minneapolis, Minnesota, USA pdahm@umn.edu.
Impact · CAMcMaster University · CAMinneapolis VA Medical Center · USMonash University · AUUniversity of Minnesota · USVA Connecticut Healthcare System · USVelindre Cancer Centre · GBYonsei University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the efficacy and safety of prostate-specific antigen (PSA) testing to screen for prostate cancer.

designSystematic review and meta-analysis. DATA SOURCES: Electronic search of Cochrane Central Register of Controlled Trials, Web of Science, Embase, Scopus, OpenGrey, LILACS, and Medline, and search of scientific meeting abstracts and trial registers to April 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials comparing PSA screening with usual care in men without a diagnosis of prostate cancer. DATA EXTRACTION: At least two reviewers screened studies, extracted data, and assessed the quality of eligible studies. A parallel guideline committee

resultsFive randomised controlled trials, enrolling 721 718 men, were included. Studies varied with respect to screening frequency and intervals, PSA thresholds for biopsy, and risk of bias. When considering the whole body of evidence, screening probably has no effect on all-cause mortality (IRR 0.99, 95% CI 0.98 to 1.01; moderate certainty) and may have no effect on prostate-specific mortality (IRR 0.96, 0.85 to 1.08; low certainty). Sensitivity analysis of studies at lower risk of bias (n=1) also demonstrates that screening seems to have no effect on all-cause mortality (IRR 1.0, 0.98 to 1.02; moderate certainty) but may have a small effect on prostate-specific mortality (IRR 0.79, 0.69 to 0.91; moderate certainty). This corresponds to one less death from prostate cancer per 1000 men screened over 10 years. Direct comparative data on biopsy and treatment related complications from the included trials were limited. Using modelling, we estimated that for every 1000 men screened, approximately 1, 3, and 25 more men would be hospitalised for sepsis, require pads for urinary incontinence, and report erectile dysfunction, respectively.

conclusionsAt best, screening for prostate cancer leads to a small reduction in disease-specific mortality over 10 years but has does not affect overall mortality. Clinicians and patients considering PSA based screening need to weigh these benefits against the potential short and long term harms of screening, including complications from biopsies and subsequent treatment, as well as the risk of overdiagnosis and overtreatment. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42016042347.

Indexed as

AgedBiopsyEarly Detection of CancerErectile DysfunctionHumansMagnetic Resonance ImagingMaleMass ScreeningMedical OveruseMiddle AgedProstate-Specific AntigenProstatic NeoplasmsRandomized Controlled Trials as TopicUrinary IncontinenceProstate-Specific Antigen

Identifiers

PMID30185521
PMCPMC6283370
OpenAlexW2892147080

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.