[Controversial guidelines in early diagnosis of prostate cancer].
In prostate cancer prevention the American College of Physicians has endorsed a clinical practice guideline: it is recommended that physicians share the decision with the patient. There is no information about its adaptation to actual circumstances and particularly in our country. This presentation has the aim of analyzing the evidence and introduces a local perspective. There is no demonstration of survival or life quality improvement in preventing prostate cancer. Therapeutic interventions have a high rate of associated morbidity and mortality. Although desirable, sharing decisions has not yet proved its validity. In our country, due to the fragile equilibrium between risks and benefits, it seems advisable to wait for stronger scientific evidence. It is recommended to the clinician to: abstain from offering early diagnosis in the healthy adult, be reluctant when asked, share decisions when it seems advisable based on patient's characteristics and inform about the probability of prostate cancer in high risk groups.
Casal
Enrique R
ER
Programa de Medicina Interna General, Departamento de Medicina, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires. ecasal@arnet.com.ar
Majdalani
Maria P
MP
D003657:Decision Making; D006801:Humans; D008297:Male; D010358:Patient Participation; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000628:therapy; D011788:Quality of Life; D012306:Risk