Prostate cancer screening

A decision analysis

S. B. Cantor, S. J. Spann, R. J. Volk, M. P. Cardenas, M. M. Warren

    Research output: Contribution to journalArticle

    51 Citations (Scopus)

    Abstract

    Background: The issue of whether to screen men for prostate cancer is controversial. No randomized clinical trials have been completed to confirm the efficacy of screening for prostate cancer. We created a mathematical model of the clinical risks and benefits of screening for prostate cancer. Methods: A Markov decision-analytic model evaluated the outcomes of annually screening asymptomatic men for prostate cancer beginning at age 50 years. The screening and testing algorithm included the digital rectal examination, transrectal ultrasound, and prostate-specific antigen test. A sample of 10 male patients with no history of prostate disease were interviewed to assess their utilities (preferences) regarding the various adverse outcomes of prostate cancer treatment. Results: The modal indicated that no screening was preferred to screening when patients' utilities were considered (24.14 vs 23.47 quality-adjusted life years expected). The optimal decision was sensitive to the utilities of impotence and urethral stricture, the most common adverse outcomes for patients under the age of 65 years. When adverse outcomes of treatment were ignored, screening was favored (24.86 vs 24.22 years of life expectancy). Conclusions: When quality-of-life preferences of men are considered, the annual screening of asymptomatic patients for prostate cancer is not recommended.

    Original languageEnglish (US)
    Pages (from-to)33-41
    Number of pages9
    JournalJournal of Family Practice
    Volume41
    Issue number1
    StatePublished - 1995

    Fingerprint

    Decision Support Techniques
    Early Detection of Cancer
    Prostatic Neoplasms
    Urethral Stricture
    Digital Rectal Examination
    Quality-Adjusted Life Years
    Erectile Dysfunction
    Prostate-Specific Antigen
    Life Expectancy
    Prostate
    Theoretical Models
    Randomized Controlled Trials
    Quality of Life

    Keywords

    • diagnostic tests, routine
    • Medical decision making
    • primary health care
    • prostate cancer
    • prostatic diseases
    • prostatic neoplasm
    • quality of life
    • screening
    • utilities

    ASJC Scopus subject areas

    • Public Health, Environmental and Occupational Health

    Cite this

    Cantor, S. B., Spann, S. J., Volk, R. J., Cardenas, M. P., & Warren, M. M. (1995). Prostate cancer screening: A decision analysis. Journal of Family Practice, 41(1), 33-41.

    Prostate cancer screening : A decision analysis. / Cantor, S. B.; Spann, S. J.; Volk, R. J.; Cardenas, M. P.; Warren, M. M.

    In: Journal of Family Practice, Vol. 41, No. 1, 1995, p. 33-41.

    Research output: Contribution to journalArticle

    Cantor, SB, Spann, SJ, Volk, RJ, Cardenas, MP & Warren, MM 1995, 'Prostate cancer screening: A decision analysis', Journal of Family Practice, vol. 41, no. 1, pp. 33-41.
    Cantor SB, Spann SJ, Volk RJ, Cardenas MP, Warren MM. Prostate cancer screening: A decision analysis. Journal of Family Practice. 1995;41(1):33-41.
    Cantor, S. B. ; Spann, S. J. ; Volk, R. J. ; Cardenas, M. P. ; Warren, M. M. / Prostate cancer screening : A decision analysis. In: Journal of Family Practice. 1995 ; Vol. 41, No. 1. pp. 33-41.
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