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Prostate Cancer Screening, Choosing Whether or Not to Screen (New!)

Prostate Cancer Screening

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Your options according to your priorities

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  • Get screened on average twice over a 13-year period
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  • Get screened on average twice over a 13-year period

    Benefits of screening
    Survival

    For every 1,000 men who undergo screening, 1 death from prostate cancer is avoided thanks to screening (0.1 %).

    • Learn more about the studies
      Studies description
      Death is avoided for...

      99.5% of men

      99.6% of men

      0.1% of men

      With Without Impact
      Confidence in these results: Moderate

      Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

      This study presents a high risk of bias.

      Studies and references

      Schröder et coll. [2014]. Lancet 384(9959):2027-2035.

      Design: Randomized multi-center trial; Participants: 162,243 men between the ages of 55 and 69 from 7 countries in Europe; Intervention: PSA screening, on average twice over a 13-year period (PSA cut-off level: 3-4 ng/mL).

    Reassurance

    For every 1,000 men, about 760 get a negative screening result. These men are initially reassured.

    • Learn more about the studies
      Studies description
      A sense of reassurance is felt by...

      76% of men

      0% of men

      76% of men

      With Without Impact
      Confidence in these results: Moderate

      Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

      This study presents a high risk of bias.

      Studies and references

      Schröder et coll. [2014]. Lancet 384(9959):2027-2035.

      Design: Randomized multi-center trial; Participants: 162,243 men between the ages of 55 and 69 from 7 countries in Europe; Intervention: PSA screening, on average twice over a 13-year period (PSA cut-off level: 3-4 ng/mL).

    Cancer severity at time of diagnosis

    For every 1,000 men who undergo screening, 100 have prostate cancer. Cancer is, on average, less severe in these men compared to men who have not been screened.

    • Learn more about the studies
      Studies description
      Getting an earlier treatment is possible for...

      10% of men

      0% of men

      10% of men

      With Without Impact
      Confidence in these results: Moderate

      Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

      This study presents a high risk of bias.

      Studies and references

      Schröder et al. [2014]. Lancet 384(9959):2027-2035.

      Design: Randomized multi-center trial; Participants: 162,243 men between the ages of 55 and 69 from 7 countries in Europe; Intervention: PSA screening, on average twice over a 13-year period (PSA cut-off level: 3-4 ng/mL).

    Harms of of screening
    False reassurance

    Of these 760 men identified as having a negative screening result, about 27 actually have prostate cancer. These men have been falsely reassured.

    • Learn more about the studies
      Studies description
      A false sense of reassurance is felt by...

      27% of the 1,000 men who get screened

      0% of the 1,000 men who do not get sceeened

      27% of men

      With Without Impact
      Confidence in these results: Moderate

      Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

      This study presents a high risk of bias.

      Studies and references

      Schröder et coll. [2014]. Lancet 384(9959):2027-2035.

      Design: Randomized multi-center trial; Participants: 162,243 men between the ages of 55 and 69 from 7 countries in Europe; Intervention: PSA screening, on average twice over a 13-year period (PSA cut-off level: 3-4 ng/mL).

    False alarm

    For every 1,000 men screened, about 240 require additional tests to confirm the presence of prostate cancer. Of these, for approximately 140 it will have been a false alarm as they do not actually have prostate cancer. These men will have experienced unnecessary anxiety.

    Of these 140 men who received a false alarm, about 120 have an unnecessary biopsy. Of these: 

    • about 2 are hospitalized;
    • about 28 experience moderate to severe complications (pain, fever, temporary urinary problems).
    • Learn more about the studies
      Studies description
      Screening results in a false alarm for...

      14% of men

      0% of men

      14% of men

      With Without Impact
      Confidence in these results: Moderate

      Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

      This study presents a high risk of bias.

      Studies and references

      Schröder et coll. [2014]. Lancet 384(9959):2027-2035.

      Devis: essai clinique à répartition aléatoire; Participants: 162 243 hommes âgés de 55 à 69 ans provenant de 7 pays européens; Intervention: Dépistage par le test de dosage de l'APS, en moyenne deux fois au cours d'un suivi de 13 ans  (seuil d’APS utilisé : 3-4 ng/mL).

    Overdiagnosis and overtreatment

    For every 1,000 men screened, about 100 receive a prostate cancer diagnosis after screening, and the majority will be treated.

    Of the 100 men whose diagnosis is confirmed, about 40 would never have known they had cancer if they had not been diagnosed. Overdiagnosis is the discovery of cancer that would have never been detected without screening. This cancer would never have had an impact on the health or life of the person. If these men decide to undergo treatment, they could experience harmful effects of unnecessary treatments such as impotence or urinary incontinence.

    • Learn more about the studies
      Studies description
      Overdiagnosis occurs in...

      4% of screened men

      0% of unscreened men

      4% of men

      With Without Impact
      Confidence in these results: Moderate

      Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

      This study presents a high risk of bias.

      Studies and references

      Schröder et coll. [2014]. Lancet 384(9959):2027-2035.

      Design: Randomized multi-center trial; Participants: 162,243 men between the ages of 55 and 69 from 7 countries in Europe; Intervention: PSA screening, on average twice over a 13-year period (PSA cut-off level: 3-4 ng/mL).

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  • Do not get screened
    Learn more about
    this option
  • Do not get screened

    Benefits to not get screened
    Unecessary tests

    For every 1,000 men who choose not to get screened, about 932 do not have prostate cancer. These men will not have an unnecessary screening test or a biopsy to see if they really have cancer.

    • Learn more about the studies
      Studies description
      Confidence in these results: Moderate

      Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

      This study presents a high risk of bias.

      Studies and references

      Schröder et coll. [2014]. Lancet 384(9959):2027-2035.

      Design: Randomized multi-center trial; Participants: 162,243 men between the ages of 55 and 69 from 7 countries in Europe; Intervention: PSA screening, on average twice over a 13-year period (PSA cut-off level: 3-4 ng/mL).

    Anxiety

    Men who do not get screened avoid the anxiety and stress caused by waiting for screening and biopsy results.

    Overdiagnosis

    Of every 1,000 men who choose not to get screened, about 40 avoid overdiagnosis as well as treatments and their possible complications.

    • Learn more about the studies
      Studies description
      Confidence in these results: Moderate

      Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

      This study presents a high risk of bias.

      Studies and references

      Schröder et coll. [2014]. Lancet 384(9959):2027-2035.

      Design: Randomized multi-center trial; Participants: 162,243 men between the ages of 55 and 69 from 7 countries in Europe; Intervention: PSA screening, on average twice over a 13-year period (PSA cut-off level: 3-4 ng/mL).

    Harms to not get screened
    Mortality

    For every 1,000 men who choose not to get screened, 6 die of prostate cancer. Of these 6 men, 1 death by prostate cancer could have been avoided if the man had opted to get screened and treated.

    • Learn more about the studies
      Studies description
      Confidence in these results: Moderate

      Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

      This study presents a high risk of bias.

      Studies and references

      Schröder et coll. [2014]. Lancet 384(9959):2027-2035.

      Design: Randomized multi-center trial; Participants: 162,243 men between the ages of 55 and 69 from 7 countries in Europe; Intervention: PSA screening, on average twice over a 13-year period (PSA cut-off level: 3-4 ng/mL).

    Cancer severity at time of diagnosis

    For every 1,000 men who choose not to get screened, 68 have cancer diagnosis after the onset of symptoms. On average, cancer is more severe in these men compared to men who have been screened.

    • Learn more about the studies
      Studies description
      Confidence in these results: Moderate

      Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.

      This study presents a high risk of bias.

      Studies and references

      Schröder et coll. [2014]. Lancet 384(9959):2027-2035.

      Design: Randomized multi-center trial; Participants: 162,243 men between the ages of 55 and 69 from 7 countries in Europe; Intervention: PSA screening, on average twice over a 13-year period (PSA cut-off level: 3-4 ng/mL).

    Close this option

Version 1.0

Publication date: August 2018 - Evidence update: January 2018 - Next update: August 2019