Evidence map›Paper›PMID 31194773›Full record

ArticlePloS one2019

Time trends in prostate cancer screening in Swiss primary care (2010 to 2017) - A retrospective study.

Stefan Zechmann, Stefania Di Gangi, Vladimir Kaplan, Rahel Meier, Thomas Rosemann, Fabio Valeri, Oliver Senn, FIRE Study Group

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 35% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
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 2 institutions in 1 country.

Stefan ZechmannInstitute of Primary Care, University of Zurich, University Hospital Zurich, Zurich, Switzerland.ORCID 0000-0001-5012-0068
Stefania Di GangiInstitute of Primary Care, University of Zurich, University Hospital Zurich, Zurich, Switzerland.
Vladimir KaplanDepartment of Internal Medicine, Hospital Muri, Muri, Switzerland.
Rahel MeierInstitute of Primary Care, University of Zurich, University Hospital Zurich, Zurich, Switzerland.
Thomas RosemannInstitute of Primary Care, University of Zurich, University Hospital Zurich, Zurich, Switzerland.ORCID 0000-0002-6436-6306
Fabio ValeriInstitute of Primary Care, University of Zurich, University Hospital Zurich, Zurich, Switzerland.
Oliver SennInstitute of Primary Care, University of Zurich, University Hospital Zurich, Zurich, Switzerland.
FIRE Study Group
University of Zurich · CHSpital Muri · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFollowing years of controversy regarding screening for prostate cancer using prostate-specific antigen, evidence evolves towards a more restrained and preference-based use. This study reports the impact of landmark trials and updated recommendations on the incidence rate of prostate cancer screening by Swiss general practitioners.

methodsWe performed a retrospective analysis of primary care data, separated in 3 time periods based on dates of publications of important prostate-specific antigen screening recommendations. 1: 2010-mid 2012 including 2 updates; 2: mid 2012-mid 2014 including a Smarter Medicine recommendation; 3: mid-2014-mid-2017 maintenance period. Period 2 including the Smarter Medicine recommendation was defined as reference period. We further assessed the influence of patient's age and the number of prostate-specific-antigen (PSA) tests, by the patient and within each time period, on the mean PSA concentration. Uni- and multivariable analyses were used as needed.

results36,800 men aged 55 to 75 years were included. 14.6% had ≥ 2 chronic conditions, 11.7% had ≥ 1 prostate-specific antigen test, (mean 2.60 ng/ml [SD 12.3]). 113,921 patient-years were covered. Data derived from 221 general practitioners, 33.5% of GP were women, mean age was 49.4 years (SD 10.0), 67.9% used prostate-specific antigen testing. Adjusted incidence rate-ratio (95%-CI) dropped significantly over time periods: Reference Period 2: incidence rate-ratio 1.00; Period 1: incidence rate-ratio 1.74 (1.59-1.90); Period 3: incidence rate-ratio 0.61 (0.56-0.67). A higher number of chronic conditions and a patient age between 60-69 years were significantly associated with higher screening rate. Increasing numbers of PSA testing per patient, as well as increasing age, were independently and significantly associated with an increase in the PSA value.

conclusionSwiss general practitioners adapted screening behavior as early as evidence of a limited health benefit evolved, while using a risk-adapted approach whenever performing multiple testing. Updated recommendations might have helped to maintain this decrease. Further recommendations and campaigns should aimed at older patients with multimorbidity, to sustain a further decline in prostate-specific antigen screening practices.

Indexed as

AgedEarly Detection of CancerGeneral PractitionersHumansIncidenceKallikreinsMaleMass ScreeningMiddle AgedPrimary Health CareProstate-Specific AntigenProstatic NeoplasmsRetrospective StudiesSwitzerlandKallikreinsKLK3 protein, humanProstate-Specific Antigen

Identifiers

PMID31194773
PMCPMC6565361
OpenAlexW2951888019

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.