title: Early detection of prostate cancer: AUA Guideline.
abstract: OBJECTIVE
  The guideline purpose is to provide the urologist with a framework for the early detection of prostate cancer in asymptomatic average risk men.
  
  
  METHODS
  A systematic review was conducted and summarized evidence derived from over 300 studies that addressed the predefined outcomes of interest (prostate cancer incidence/mortality, quality of life, diagnostic accuracy and harms of testing). In addition to the quality of evidence, the panel considered values and preferences expressed in a clinical setting (patient-physician dyad) rather than having a public health perspective. Guideline statements were organized by age group in years (age <40; 40 to 54; 55 to 69; ≥ 70).
  
  
  RESULTS
  Except prostate specific antigen-based prostate cancer screening, there was minimal evidence to assess the outcomes of interest for other tests. The quality of evidence for the benefits of screening was moderate, and evidence for harm was high for men age 55 to 69 years. For men outside this age range, evidence was lacking for benefit, but the harms of screening, including over diagnosis and overtreatment, remained. Modeled data suggested that a screening interval of two years or more may be preferred to reduce the harms of screening.
  
  
  CONCLUSIONS
  The Panel recommended shared decision-making for men age 55 to 69 years considering PSA-based screening, a target age group for whom benefits may outweigh harms. Outside this age range, PSA-based screening as a routine could not be recommended based on the available evidence.
authors: American Urological Association Education and Research, Inc., Linthicum, Maryland, USA.
authors: H Ballentine
authors: HB
authors: Carter
authors: Peter C
authors: PC
authors: Albertsen
authors: Michael J
authors: MJ
authors: Barry
authors: Ruth
authors: R
authors: Etzioni
authors: Stephen J
authors: SJ
authors: Freedland
authors: Kirsten Lynn
authors: KL
authors: Greene
authors: Lars
authors: L
authors: Holmberg
authors: Philip
authors: P
authors: Kantoff
authors: Badrinath R
authors: BR
authors: Konety
authors: Mohammad Hassan
authors: MH
authors: Murad
authors: David F
authors: DF
authors: Penson
authors: Anthony L
authors: AL
authors: Zietman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003657:Decision Making; D055088:Early Detection of Cancer / Q000592:standards*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012307:Risk Factors
chemical_list: D017430:Prostate-Specific Antigen
keywords: DRE; ERSPC; European Randomized Study of Screening for Prostate Cancer; FDA; Food and Drug Administration; PLCO; PSA; Prostate Lung, Colorectal and Ovarian; RCT; digital rectal examination; early detection of cancer; prostate specific antigen; prostate-specific antigen; prostatic neoplasms; randomized controlled trial
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