Screening for prostate cancer: a Cochrane systematic review.
OBJECTIVE
The objective of this systematic review was to determine whether screening for prostate cancer reduces prostate cancer mortality.


METHODS
A systematic search for randomised controlled trials was conducted through electronic scientific databases and a specialist register of the Cochrane Prostatic Diseases and Urologic Cancers Group. Manual searching of specific journals was also conducted. Two authors independently reviewed studies that met the inclusion criteria. Studies were independently assessed for quality. Data from included studies was also extracted independently.


RESULTS
Two randomised controlled trials were included however, both trials had methodological weaknesses. Re-analysis of the reported data using intention-to-screen and meta-analysis indicated no statistically significant difference in prostate cancer mortality between men randomized for prostate cancer screening and controls (RR 1.01, 95% CI: 0.80-1.29).


CONCLUSIONS
Given that only two randomised controlled trials were included, and the high risk of bias of both trials, there is insufficient evidence to either support or refute the routine use of screening compared to no screening for reducing prostate cancer mortality. Currently, no robust evidence from randomised controlled trials is available regarding the impact of screening on quality of life, harms of screening, or its economic value. Results from two ongoing large scale multi-center randomised controlled trials, which will be available in the upcoming few years, will assist patients and health professionals in making an evidence-based decision regarding the effectiveness of screening for prostate cancer.
Ilic
Dragan
D
Monash Institute of Health Services Research, Monash Medical Centre, Monash University, Locked Bag 29, Clayton, VIC, 3168, Australia. dragan.ilic@med.monash.edu.au
O'Connor
Denise
D
Green
Sally
S
Wilt
Timothy
T
D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic