programas cribado cancer

Nota bibliográfica cribado c próstata 2014-03

Gulati R, Inoue LYT, Gore JL, Katcher J, Etzioni R. Individualized Estimates of Overdiagnosis in Screen-Detected Prostate Cancer. J Natl Cancer Inst. 2014;106(2). Available from: http://jnci.oxfordjournals.org/content/106/2/djt367.abstract.         doi:10.1093/jnci/djt367.

Conclusions The chances of overdiagnosis vary considerably by age, Gleason score, and PSA at diagnosis. The overdiagnosis nomogram presents tailored estimates of these risks based on patient and tumor information known at diagnosis and can be used to inform decisions about treating PSA-detected prostate cancers.

Carlsson S, Assel M, Sjoberg D, Ulmert D, Hugosson J, Lilja H, et al. Influence of blood prostate specific antigen levels at age 60 on benefits and harms of prostate cancer screening: population based cohort study. BMJ. 2014;348.

Conclusions The ratio of benefits to harms of PSA screening varies noticeably with blood PSA levels at age 60. For men with a PSA level <1 ng/mL at age 60, no further screening is recommended. Continuing to screen men with PSA levels >2 ng/mL at age 60 is beneficial, with the number needed to screen and treat being extremely favourable. Screening men with a PSA level of 1-2 ng/mL is an individual decision to be based on a discussion between patient and doctor.

Hayes JH, Barry MJ. Screening for Prostate Cancer With the Prostate-Specific Antigen Test. JAMA. 2014;311(11):1143. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24643604. doi: 10.1001/jama.2014.2085. PMID: 24643604.

CONCLUSIONS AND RELEVANCE: Available evidence favors clinician discussion of the pros and cons of PSA screening with average-risk men aged 55 to 69 years. Only men who express a definite preference for screening should have PSA testing. Other strategies to mitigate the potential harms of screening include considering biennial screening, a higher PSA threshold for biopsy, and conservative therapy for men receiving a new diagnosis of prostate cancer
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