programas cribado cancer


Nota Bibliográfica

Esta Nota es una recopilación de publicaciones (artículos, informes, libros) sobre cribado de cáncer resultado de una revisión no sistemática de la literatura.

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Josep A Espinás. Pla Director d'Oncología de Catalunya.
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Nota bibliográfica cribado c próstata 2014-11

Kitagawa Y, Sawada K, Urata S, Izumi K, Ueno S, Kadono Y, et al. Impact of PSA Levels on Second-round Screening for the Development of Prostate Cancer in Men with Low Baseline PSA Levels (Anticancer Res. Greece; 2014;34(11):6739–46. PMID: 25368284.

CONCLUSION: The present study demonstrated that serum PSA levels at second round screening were a strong predictor of cancer development in men with baseline PSA levels ng/ml at the first population screening.

Prasad V. It is time to stop screening for prostate cancer. JAMA Intern Med. United States; 2014;174(11):1841–2. doi: 10.1001/jamainternmed.2014.3078.
PMID: 25178980.

Louie KS, Seigneurin A, Cathcart P, Sasieni P. Do prostate cancer risk models improve the predictive accuracy of PSA screening? A meta-analysis. Ann Oncol. 2014; Available from: doi: 10.1093/annonc/mdu525.

Conclusions Risk prediction models improve the predictive accuracy of PSA testing to detect PCa. Future developments in the use of PCa risk models should evaluate its clinical effectiveness in practice


Nota bibliográfica cribado c próstata 2014-10

Ghodsbin F, Zare M, Jahanbin I, Ariafar A, Keshavarzi S. A Survey of the Knowledge and Beliefs of Retired Men about Prostate Cancer Screening Based on Health Belief Model. Int J community based Nurs midwifery. Iran; 2014;2(4):279–85. PMID: 25349871.

CONCLUSION: Developing an assessment based on HBM could be effective in designing and implementing educational programs by helping to identify the needs and priorities of the target population.

Randazzo M, Beatrice J, Huber A, Grobholz R, Manka L, Wyler SF, et al. Influence of metformin use on PSA values, free-to-total PSA, prostate cancer incidence and grade and overall survival in a prospective screening trial (ERSPC Aarau). World J Urol. 2014; doi: 10.1007/s00345-014-1426-y. PMID: 25358675.

CONCLUSION: No significant differences in PSA levels or PCa incidence and grade were observed. The slightly higher f/t-ratio did not result in lower PCa detection rate. Metformin users were at significantly higher risk of all-cause mortality. The relatively small number of men on metformin is a main limitation of the study.

Black A. A targeted approach reduces prostate cancer-specific (PSA) screening harms while preserving benefits. Evid Based Med. England; 2014;19(5):186. doi: 10.1136/ebmed-2014-110018. PMID: 24939923


Nota bibliográfica cribado c próstata 2014-07/08

Pataky R, Gulati R, Etzioni R, Black P, Chi KN, Coldman AJ, et al. Is prostate cancer screening cost-effective? A microsimulation model of prostate-specific antigen-based screening for British Columbia, Canada. Int J Cancer. 2014;135(4):939–47. Available from:  doi: 10.1002/ijc.28732. PMID: 24443367.
Prostate-specific antigen (PSA) screening for prostate cancer may reduce mortality, but it incurs considerable risk of over diagnosis and potential harm to quality of life. Our objective was to evaluate the cost-effectiveness of PSA screening, with and without adjustment for quality of life, for the British Columbia (BC) population. We adapted an existing natural history model using BC incidence, treatment, cost and mortality patterns. The modeled mortality benefit of screening derives from a stage-shift mechanism, assuming mortality reduction consistent with the European Study of Randomized Screening for Prostate Cancer. The model projected outcomes for 40-year-old men under 14 combinations of screening ages and frequencies. Cost and utility estimates were explored with deterministic sensitivity analysis. The incremental cost-effectiveness of regular screening ranged from $36,300/LYG, for screening every four years from ages 55 to 69 years, to $588,300/LYG, for screening every two years from ages 40 to 74 years. The marginal benefits of increasing screening frequency to 2 years or starting screening at age 40 years were small and came at significant cost. After utility adjustment, all screening strategies resulted in a loss of quality-adjusted life years (QALYs); however, this result was very sensitive to utility estimates. Plausible outcomes under a range of screening strategies inform discussion of prostate cancer screening policy in BC and similar jurisdictions. Screening may be cost-effective, but the sensitivity of results to utility values suggests individual preferences for quality versus quantity of life should be a key consideration.


Nota bibliográfica cribado c próstata 2014-05

Etzioni RD, Thompson IM. What do the screening trials really tell us and where do we go from here? Urol Clin North Am. 2014;41(2):223–8. Available from: doi: 10.1016/j.ucl.2014.01.002. PMID: 24725484.

Publication of apparently conflicting results from 2 large trials of prostate cancer screening has intensified the debate about prostate-specific antigen (PSA) testing and has led to a recommendation against screening from the US Preventive Services Task Force. This article reviews the trials and discusses the limitations of their empirical results in informing public health policy. In particular, the authors explain why harm-benefit trade-offs based on empirical results may not accurately reflect the trade-offs expected under long-term population screening. This information should be useful to clinicians in understanding the implications of these studies regarding the value of PSA screening.

Roobol MJ. International perspectives on screening. Urol Clin North Am. 2014;41(2):237–47. Available from: doi: 10.1016/j.ucl.2014.01.009. PMID: 24725486.

The estimated population of the world in 2008 was 6.75 billion people, increasing by around 79 million people each year. The world population is aging. In 1970, the world median age was 22 years; it is projected to reach 38 years by 2050. The number of people in the world aged 60 years and older is expected to almost triple to 2 billion by 2050. Because cancer, especially prostate cancer, is predominantly a disease of the elderly, increases in the number of older people will lead to more cases of cancer, even if current incidence rates remain the same.

Kaffenberger SD, Penson DF. The politics of prostate cancer screening. Urol Clin North Am. 2014;41(2):249–55. Available from: doi: 10.1016/j.ucl.2014.01.004. PMID: 24725487.

The controversial recent recommendation by the United States Preventive Services Task Force (USPSTF) against prostate-specific antigen (PSA) screening for early-stage prostate cancer has caused much debate. Whereas USPSTF recommendations against routine screening mammography in younger women resulted in fierce public outcry and eventual alteration in the language of the recommendation, the same public and political response has not been seen with PSA screening for prostate cancer. It is of paramount importance to ensure improved efficiency and transparency of the USPSTF recommendation process, and resolution of concerns with the current USPSTF recommendation against PSA screening for all ages.

Knight SJ. Decision making and prostate cancer screening. Urol Clin North Am. 2014;41(2):257–66. Available from: doi: 10.1016/j.ucl.2014.01.008. PMID: 24725488.

This article presents an overview of the challenges that men encounter in making decisions about prostate cancer screening, including complex affective and cognitive factors and controversies in the interpretation of the evidence on prostate cancer screening. Shared decision making involving patient decision aids are discussed as approaches that can be used to improve the quality of prostate cancer screening decisions, including a close alignment between a man’s values, goals, and preferences and his choice about screening.

Bryant RJ, Lilja H. Emerging PSA-based tests to improve screening. Urol Clin North Am. 2014;41(2):267–76. Available from: doi: 10.1016/j.ucl.2014.01.003. PMID: 24725489.

This article updates advances in prostate cancer screening based on prostate-specific antigen, its derivatives, and human kallikrein markers. Many men are diagnosed with indolent disease not requiring treatment. Although there is evidence of a survival benefit from screening, the numbers needed to screen and treat remain high. There is risk of exposing men to the side effects of treatment for nonthreatening disease. A screening test is needed with sufficiently good performance characteristics to detect disease at an early stage so treatment may be offered with curative intent, while reducing the number of negative or unnecessary biopsies.

Taneja SS. Early detection of prostate cancer. Urol Clin North Am. 2014;41(2):xi–xii. Available from: doi: 10.1016/j.ucl.2014.03.002. PMID: 24725495.

Loeb S, Cooperberg MR. Early detection of prostate cancer. Urol Clin North Am. 2014;41(2):xiii. Available from: doi: 10.1016/j.ucl.2014.03.001. PMID: 24725496


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