Prostate cancer is the third leading cause of cancer death in Canadian men. The lifetime risk of developing prostate cancer is estimated around 14.2%, while the risk of dying from this cancer is 3.7%. In most cases, prostate cancer grows slowly and most men die due to causes other than prostate cancer even before the cancer becomes clinically evident.

Survival from prostate cancer depends largely on the progression of tumor at the time of diagnosis. The early detection of prostate cancer is believed to reduce the prostate cancer morbidity. However, earlier detection may also result in over-diagnosis and over-treatment of mild forms of prostate cancer; the treatment of such cancers might be more aggressive than the cancer itself. The debate over prostate cancer screening became more prominent by the introduction of the prostate-specific antigen (PSA) test for the detection of prostate cancer. The PSA testing was shown to be very sensitive, and has contributed the increase of prostate cancer incidence since 1990. Despite the wide adoption of PSA testing in prostate cancer screening, the evidence supporting its use still unclear.

Several clinical guidelines have been developed to organize and orient prostate cancer screening programs. The objective of this review is to evaluate the quality of the North American guidelines on prostate cancer screening.

Contents

• CONTEXT AND POLICY ISSUES
• RESEARCH QUESTIONS
• KEY FINDINGS
• METHODS
  • Literature Search Strategy
  • Selection Criteria and Methods
  • Exclusion Criteria
  • Critical Appraisal of Individual Studies
• SUMMARY OF EVIDENCE
  • Quantity of Research Available
  • Summary of Study Characteristics
  • Summary of Critical Appraisal
  • Summary of Findings
  • Limitations
• CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING
• REFERENCES
• APPENDIX I SELECTION OF INCLUDED STUDIES
• APPENDIX II CHARACTERISTICS OF THE INCLUDED GUIDELINES
• APPENDIX III CRITICAL APPRAISAL OF THE INCLUDED GUIDELINES
• APPENDIX IV MAIN RECOMMENDATIONS OF THE INCLUDED GUIDELINES

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.