Evidence map›Paper›PMID 41040538›Full record

ReviewLancet regional health. Americas2025

Is it time for Canada to revisit its approach to prostate cancer screening?

David-Dan Nguyen, Aisha Lofters, Christopher J D Wallis, Alexandre R Zlotta, Neil E Fleshner, Quoc-Dien Trinh, Antonio Finelli, Laura C Rosella, Allan S Detsky, Monique J Roobol and 1 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Lancet regional health. Americas, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

11 authors.

David-Dan NguyenDivision of Urology, Department of Surgery, University of Toronto, ON, Canada.
Aisha LoftersDepartment of Family and Community Medicine, Women's College Hospital, University of Toronto, Toronto, ON, Canada.
Christopher J D WallisDivision of Urology, Department of Surgery, University of Toronto, ON, Canada.
Alexandre R ZlottaDivision of Urology, Department of Surgery, University of Toronto, ON, Canada.
Neil E FleshnerDivision of Urology, Department of Surgery, University of Toronto, ON, Canada.
Quoc-Dien TrinhDepartment of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Antonio FinelliDivision of Urology, Department of Surgery, University of Toronto, ON, Canada.
Laura C RosellaDepartment of Epidemiology, Dalla Lana School of Public Health, University of Toronto, ON, Canada.
Allan S DetskyInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, ON, Canada.
Monique J RoobolDepartment of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands.
Girish S KulkarniDivision of Urology, Department of Surgery, University of Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Prostate cancer is the third leading cause of cancer death among Canadian men. Despite advances in the last decade mitigating overdiagnosis and overtreatment, Canadian guidelines have recommended against routine prostate-specific antigen (PSA) screening since 2014. This has resulted in opportunistic screening, marked by inequitable access, low-value testing, and missed opportunities for early detection. We review global policy developments, emerging trial data, and implementation strategies, which suggest that organised, risk-stratified screening may improve outcomes and equity. However, overdiagnosis and associated harms remain a concern within organised programs. To address this uncertainty and generate timely, policy-relevant evidence, we propose implementing population-wide, adaptive platform trials embedded in the healthcare system. This design would enable real-time integration of new technologies, standardised protocols, and equitable access-hallmarks of a learning healthcare system. Such a model could help Canada modernise prostate cancer screening while carefully weighing benefits, harms, and equity in a rapidly evolving landscape.

Indexed as

OrganizedPolicyProstate cancerScreening

Identifiers

PMID41040538
PMCPMC12485535

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.