Editorials

Screening for prostate cancer in younger men

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39385.491424.80 (Published 29 November 2007) Cite this as: BMJ 2007;335:1105
  1. Dragan Ilic, senior lecturer,
  2. Sally Green, professor
  1. Monash Institute of Health Services Research, Monash University, Locked Bag 29, Monash Medical Centre, Clayton VIC 3168, Australia
  1. dragan.ilic{at}med.monash.edu.au

    Clinicians should promote informed decision making while awaiting definitive evidence from RCTs

    Current policies on screening for prostate cancer vary worldwide. This discrepancy can be explained in part by the lack of clear evidence to support or refute such screening. Evidence is lacking for the diagnostic accuracy of current screening tests (digital rectal examination and prostate specific antigen testing) and whether screening ultimately improves survival and quality of life.1 In their study in this week's BMJ, Lane and colleagues present results from the prostate testing for cancer and treatment study, which assesses the feasibility of testing for prostate cancer in younger men (45-49 years).2

    A recent systematic review1 identified two randomised controlled trials (RCTs) assessing the effectiveness of screening for prostate cancer.3 4 Both trials had several methodological weaknesses. Reanalysis of these trials using an intention to treat analysis showed no significant reduction in mortality between men randomised to screening and men in control groups (relative risk 1.01, 95% confidence interval 0.76 to 1.33). The …

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