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Evidence of Benefit

Summary of First Four Prostate, Lung, Colorectal, and Ovarian Screening Roundsa continued...

Decision analyses using the Markov model yield variable treatment outcomes because of the uncertainty regarding metastatic rates expected for prostate cancer and uncertainty about treatment efficacy.[103,104,105] A review of 59,876 men with prostate cancer diagnosed between 1983 and 1992 and registered by the SEER registries, however, shows that treatment of men with poorly differentiated and moderately differentiated disease is associated with an improved survival rate, compared with observation.[106] It is not known to what degree this can be attributed to treatment effect as opposed to other factors such as a preponderance of relatively healthy patients in the treated group. The information from Swedish studies of expectant therapy lead to different conclusions depending on methodology and populations used in analysis.[107]

Simulation modeling from the National Cancer Institute's CISNET program suggests that changes in prostate cancer treatment explain a portion of the drop in prostate cancer mortality but that most of the decline is likely the result of other factors such as screening or improvements in disease management after primary therapy.[108]

A simulation model based on available evidence suggests that if there is a benefit to screening, this benefit decreases with age.[109] No trial of prostate cancer screening in which the intervention arms were analyzed as randomized (analogous to an intention-to-treat analysis in a treatment trial) has been reported. There is insufficient evidence on which to decide the efficacy of TRUS and serum tumor markers (including PSA) for routine screening in asymptomatic men.[103,110]

Providing Information to the Public, to Patients, and to Their Families

While awaiting results of current studies, physicians and men (and their partners) are faced with the dilemma of whether to recommend or request a screening test. A qualitative study undertaken on focus groups of men, physician experts, and couples with screened and unscreened men has explored what information may help to inform a man undertaking a decision regarding PSA screening.[111] At a minimum, men should be informed about the possibility that false-positive or false-negative test results can occur, that it is not known whether regular screening will reduce the number of deaths from prostate cancer, and that among experts, the recommendation to screen is controversial. The PLCO-1, which is now closed to accrual, is following participants to test the effect of early detection by DRE and PSA on reducing mortality. A trial of screening is also being performed in Europe.[88,112]

References:

  1. Scardino PT: Early detection of prostate cancer. Urol Clin North Am 16 (4): 635-55, 1989.
  2. Sandblom G, Varenhorst E, Löfman O, et al.: Clinical consequences of screening for prostate cancer: 15 years follow-up of a randomised controlled trial in Sweden. Eur Urol 46 (6): 717-23; discussion 724, 2004.
  3. Concato J, Wells CK, Horwitz RI, et al.: The effectiveness of screening for prostate cancer: a nested case-control study. Arch Intern Med 166 (1): 38-43, 2006.
  4. Holmberg L, Bill-Axelson A, Helgesen F, et al.: A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer. N Engl J Med 347 (11): 781-9, 2002.
  5. Bill-Axelson A, Holmberg L, Ruutu M, et al.: Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med 352 (19): 1977-84, 2005.
  6. Stattin P, Holmberg E, Johansson JE, et al.: Outcomes in localized prostate cancer: National Prostate Cancer Register of Sweden follow-up study. J Natl Cancer Inst 102 (13): 950-8, 2010.
  7. Gilbertsen VA: Cancer of the prostate gland. Results of early diagnosis and therapy undertaken for cure of the disease. JAMA 215 (1): 81-4, 1971.
  8. Jenson CB, Shahon DB, Wangensteen OH: Evaluation of annual examinations in the detection of cancer: special reference to cancer of the gastrointestinal tract, prostate, breast, and female generative tract. JAMA 174(14): 1783-1788, 1960.
  9. Chodak GW, Schoenberg HW: Early detection of prostate cancer by routine screening. JAMA 252 (23): 3261-4, 1984.
  10. Chodak GW, Keller P, Schoenberg HW: Assessment of screening for prostate cancer using the digital rectal examination. J Urol 141 (5): 1136-8, 1989.
  11. Donohue RE, Fauver HE, Whitesel JA, et al.: Staging prostatic cancer: a different distribution. J Urol 122 (3): 327-9, 1979.
  12. Wajsman Z, Chu TM: Detection and diagnosis of prostatic cancer. In: Murphy GP, ed.: Prostatic cancer. Littleton, Mass: PSG Pub. Co., 1987, pp 94-99.
  13. Thompson IM, Zeidman EJ: Presentation and clinical course of patients ultimately succumbing to carcinoma of the prostate. Scand J Urol Nephrol 25 (2): 111-4, 1991.
  14. Weinmann S, Richert-Boe K, Glass AG, et al.: Prostate cancer screening and mortality: a case-control study (United States). Cancer Causes Control 15 (2): 133-8, 2004.
  15. Beemsterboer PM, Kranse R, de Koning HJ, et al.: Changing role of 3 screening modalities in the European randomized study of screening for prostate cancer (Rotterdam). Int J Cancer 84 (4): 437-41, 1999.
  16. Schröder FH, van der Maas P, Beemsterboer P, et al.: Evaluation of the digital rectal examination as a screening test for prostate cancer. Rotterdam section of the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst 90 (23): 1817-23, 1998.
  17. Jacobsen SJ, Bergstralh EJ, Katusic SK, et al.: Screening digital rectal examination and prostate cancer mortality: a population-based case-control study. Urology 52 (2): 173-9, 1998.
  18. Richert-Boe KE, Humphrey LL, Glass AG, et al.: Screening digital rectal examination and prostate cancer mortality: a case-control study. J Med Screen 5 (2): 99-103, 1998.
  19. Friedman GD, Hiatt RA, Quesenberry CP Jr, et al.: Case-control study of screening for prostatic cancer by digital rectal examinations. Lancet 337 (8756): 1526-9, 1991.
  20. Thompson IM, Tangen CM, Goodman PJ, et al.: Finasteride improves the sensitivity of digital rectal examination for prostate cancer detection. J Urol 177 (5): 1749-52, 2007.
  21. Waterhouse RL, Resnick MI: The use of transrectal prostatic ultrasonography in the evaluation of patients with prostatic carcinoma. J Urol 141 (2): 233-9, 1989.
  22. Cooner WH, Mosley BR, Rutherford CL Jr, et al.: Clinical application of transrectal ultrasonography and prostate specific antigen in the search for prostate cancer. J Urol 139 (4): 758-61, 1988.
  23. Renfer LG, Schow D, Thompson IM, et al.: Is ultrasound guidance necessary for transrectal prostate biopsy? J Urol 154 (4): 1390-1, 1995.
  24. Hodge KK, McNeal JE, Stamey TA: Ultrasound guided transrectal core biopsies of the palpably abnormal prostate. J Urol 142 (1): 66-70, 1989.
  25. Levine MA, Ittman M, Melamed J, et al.: Two consecutive sets of transrectal ultrasound guided sextant biopsies of the prostate for the detection of prostate cancer. J Urol 159 (2): 471-5; discussion 475-6, 1998.
  26. Eskew LA, Bare RL, McCullough DL: Systematic 5 region prostate biopsy is superior to sextant method for diagnosing carcinoma of the prostate. J Urol 157 (1): 199-202; discussion 202-3, 1997.
  27. Partin AW, Oesterling JE: The clinical usefulness of prostate specific antigen: update 1994. J Urol 152 (5 Pt 1): 1358-68, 1994.
  28. Thompson IM, Pauler DK, Goodman PJ, et al.: Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. N Engl J Med 350 (22): 2239-46, 2004.
  29. Thompson IM, Ankerst DP, Chi C, et al.: Operating characteristics of prostate-specific antigen in men with an initial PSA level of 3.0 ng/ml or lower. JAMA 294 (1): 66-70, 2005.
  30. Catalona WJ, Smith DS, Ratliff TL, et al.: Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. JAMA 270 (8): 948-54, 1993.
  31. Babaian RJ, Mettlin C, Kane R, et al.: The relationship of prostate-specific antigen to digital rectal examination and transrectal ultrasonography. Findings of the American Cancer Society National Prostate Cancer Detection Project. Cancer 69 (5): 1195-200, 1992.
  32. Brawer MK, Chetner MP, Beatie J, et al.: Screening for prostatic carcinoma with prostate specific antigen. J Urol 147 (3 Pt 2): 841-5, 1992.
  33. Mettlin C, Murphy GP, Lee F, et al.: Characteristics of prostate cancers detected in a multimodality early detection program. The Investigators of the American Cancer Society-National Prostate Cancer Detection Project. Cancer 72 (5): 1701-8, 1993.
  34. Collins MM, Barry MJ: Controversies in prostate cancer screening. Analogies to the early lung cancer screening debate. JAMA 276 (24): 1976-9, 1996.
  35. Gann PH, Hennekens CH, Stampfer MJ: A prospective evaluation of plasma prostate-specific antigen for detection of prostatic cancer. JAMA 273 (4): 289-94, 1995.
  36. Smith DS, Catalona WJ, Herschman JD: Longitudinal screening for prostate cancer with prostate-specific antigen. JAMA 276 (16): 1309-15, 1996 Oct 23-30.
  37. Smith DS, Carvalhal GF, Mager DE, et al.: Use of lower prostate specific antigen cutoffs for prostate cancer screening in black and white men. J Urol 160 (5): 1734-8, 1998.
  38. Moul JW, Connelly RR, Mooneyhan RM, et al.: Racial differences in tumor volume and prostate specific antigen among radical prostatectomy patients. J Urol 162 (2): 394-7, 1999.
  39. Lodding P, Aus G, Bergdahl S, et al.: Characteristics of screening detected prostate cancer in men 50 to 66 years old with 3 to 4 ng./ml. Prostate specific antigen. J Urol 159 (3): 899-903, 1998.
  40. Harris CH, Dalkin BL, Martin E, et al.: Prospective longitudinal evaluation of men with initial prostate specific antigen levels of 4.0 ng./ml. or less. J Urol 157 (5): 1740-3, 1997.
  41. Eastham JA, Riedel E, Scardino PT, et al.: Variation of serum prostate-specific antigen levels: an evaluation of year-to-year fluctuations. JAMA 289 (20): 2695-700, 2003.
  42. Carter HB, Pearson JD, Waclawiw Z, et al.: Prostate-specific antigen variability in men without prostate cancer: effect of sampling interval on prostate-specific antigen velocity. Urology 45 (4): 591-6, 1995.
  43. Andriole GL, Guess HA, Epstein JI, et al.: Treatment with finasteride preserves usefulness of prostate-specific antigen in the detection of prostate cancer: results of a randomized, double-blind, placebo-controlled clinical trial. PLESS Study Group. Proscar Long-term Efficacy and Safety Study. Urology 52 (2): 195-201; discussion 201-2, 1998.
  44. DiPaola RS, Zhang H, Lambert GH, et al.: Clinical and biologic activity of an estrogenic herbal combination (PC-SPES) in prostate cancer. N Engl J Med 339 (12): 785-91, 1998.
  45. Stenner J, Holthaus K, Mackenzie SH, et al.: The effect of ejaculation on prostate-specific antigen in a prostate cancer-screening population. Urology 51 (3): 455-9, 1998.
  46. Grubb RL 3rd, Pinsky PF, Greenlee RT, et al.: Prostate cancer screening in the Prostate, Lung, Colorectal and Ovarian cancer screening trial: update on findings from the initial four rounds of screening in a randomized trial. BJU Int 102 (11): 1524-30, 2008.
  47. Andriole GL, Grubb RL 3rd, Buys SS, et al.: Mortality results from a randomized prostate-cancer screening trial. N Engl J Med 360 (13): 1310-9, 2009.
  48. Pinsky PF, Andriole GL, Kramer BS, et al.: Prostate biopsy following a positive screen in the prostate, lung, colorectal and ovarian cancer screening trial. J Urol 173 (3): 746-50; discussion 750-1, 2005.
  49. Andriole GL, Crawford ED, Grubb RL 3rd, et al.: Prostate cancer screening in the randomized Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial: mortality results after 13 years of follow-up. J Natl Cancer Inst 104 (2): 125-32, 2012.
  50. Schröder FH, Hugosson J, Roobol MJ, et al.: Screening and prostate-cancer mortality in a randomized European study. N Engl J Med 360 (13): 1320-8, 2009.
  51. Heijnsdijk EA, Wever EM, Auvinen A, et al.: Quality-of-life effects of prostate-specific antigen screening. N Engl J Med 367 (7): 595-605, 2012.
  52. Hugosson J, Carlsson S, Aus G, et al.: Mortality results from the Göteborg randomised population-based prostate-cancer screening trial. Lancet Oncol 11 (8): 725-32, 2010.
  53. Sandblom G, Varenhorst E, Rosell J, et al.: Randomised prostate cancer screening trial: 20 year follow-up. BMJ 342: d1539, 2011.
  54. Wilt TJ, Brawer MK, Jones KM, et al.: Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med 367 (3): 203-13, 2012.
  55. PROGENSA® PCA3 Assay - P100033. Silver Spring, Md: U.S. Food and Drug Administration, 2012. Available online. Last accessed January 31, 2013.
  56. Brawer MK, Meyer GE, Letran JL, et al.: Measurement of complexed PSA improves specificity for early detection of prostate cancer. Urology 52 (3): 372-8, 1998.
  57. Hoffman RM, Clanon DL, Littenberg B, et al.: Using the free-to-total prostate-specific antigen ratio to detect prostate cancer in men with nonspecific elevations of prostate-specific antigen levels. J Gen Intern Med 15 (10): 739-48, 2000.
  58. Arcangeli CG, Humphrey PA, Smith DS, et al.: Percentage of free serum prostate-specific antigen as a predictor of pathologic features of prostate cancer in a screening population. Urology 51 (4): 558-64; discussion 564-5, 1998.
  59. Pannek J, Rittenhouse HG, Chan DW, et al.: The use of percent free prostate specific antigen for staging clinically localized prostate cancer. J Urol 159 (4): 1238-42, 1998.
  60. Taylor JA 3rd, Koff SG, Dauser DA, et al.: The relationship of ultrasensitive measurements of prostate-specific antigen levels to prostate cancer recurrence after radical prostatectomy. BJU Int 98 (3): 540-3, 2006.
  61. Sakai I, Harada K, Kurahashi T, et al.: Usefulness of the nadir value of serum prostate-specific antigen measured by an ultrasensitive assay as a predictor of biochemical recurrence after radical prostatectomy for clinically localized prostate cancer. Urol Int 76 (3): 227-31, 2006.
  62. Benson MC, Whang IS, Pantuck A, et al.: Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer. J Urol 147 (3 Pt 2): 815-6, 1992.
  63. Bangma CH, Grobbee DE, Schröder FH: Volume adjustment for intermediate prostate-specific antigen values in a screening population. Eur J Cancer 31A (1): 12-4, 1995.
  64. Babaian RJ, Kojima M, Ramirez EI, et al.: Comparative analysis of prostate specific antigen and its indexes in the detection of prostate cancer. J Urol 156 (2 Pt 1): 432-7, 1996.
  65. Djavan B, Remzi M, Zlotta AR, et al.: Combination and multivariate analysis of PSA-based parameters for prostate cancer prediction. Tech Urol 5 (2): 71-6, 1999.
  66. Horninger W, Reissigl A, Klocker H, et al.: Improvement of specificity in PSA-based screening by using PSA-transition zone density and percent free PSA in addition to total PSA levels. Prostate 37 (3): 133-7; discussion 138-9, 1998.
  67. Etzioni R, Cha R, Cowen ME: Serial prostate specific antigen screening for prostate cancer: a computer model evaluates competing strategies. J Urol 162 (3 Pt 1): 741-8, 1999.
  68. Carter HB, Pearson JD, Metter EJ, et al.: Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. JAMA 267 (16): 2215-20, 1992 Apr 22-29.
  69. Woolf SH: Screening for prostate cancer with prostate-specific antigen. An examination of the evidence. N Engl J Med 333 (21): 1401-5, 1995.
  70. Brawer MK, Beatie J, Wener MH, et al.: Screening for prostatic carcinoma with prostate specific antigen: results of the second year. J Urol 150 (1): 106-9, 1993.
  71. Ulmert D, Serio AM, O'Brien MF, et al.: Long-term prediction of prostate cancer: prostate-specific antigen (PSA) velocity is predictive but does not improve the predictive accuracy of a single PSA measurement 15 years or more before cancer diagnosis in a large, representative, unscreened population. J Clin Oncol 26 (6): 835-41, 2008.
  72. Thompson IM, Ankerst DP, Chi C, et al.: Assessing prostate cancer risk: results from the Prostate Cancer Prevention Trial. J Natl Cancer Inst 98 (8): 529-34, 2006.
  73. Schröder FH, Roobol-Bouts M, Vis AN, et al.: Prostate-specific antigen-based early detection of prostate cancer--validation of screening without rectal examination. Urology 57 (1): 83-90, 2001.
  74. Määttänen L, Auvinen A, Stenman UH, et al.: Three-year results of the Finnish prostate cancer screening trial. J Natl Cancer Inst 93 (7): 552-3, 2001.
  75. Ross KS, Carter HB, Pearson JD, et al.: Comparative efficiency of prostate-specific antigen screening strategies for prostate cancer detection. JAMA 284 (11): 1399-405, 2000.
  76. Carter HB, Landis PK, Metter EJ, et al.: Prostate-specific antigen testing of older men. J Natl Cancer Inst 91 (20): 1733-7, 1999.
  77. van der Cruijsen-Koeter IW, Roobol MJ, Wildhagen MF, et al.: Tumor characteristics and prognostic factors in two subsequent screening rounds with four-year interval within prostate cancer screening trial, ERSPC Rotterdam. Urology 68 (3): 615-20, 2006.
  78. Crawford ED, Pinsky PF, Chia D, et al.: Prostate specific antigen changes as related to the initial prostate specific antigen: data from the prostate, lung, colorectal and ovarian cancer screening trial. J Urol 175 (4): 1286-90; discussion 1290, 2006.
  79. Roobol MJ, Grenabo A, Schröder FH, et al.: Interval cancers in prostate cancer screening: comparing 2- and 4-year screening intervals in the European Randomized Study of Screening for Prostate Cancer, Gothenburg and Rotterdam. J Natl Cancer Inst 99 (17): 1296-303, 2007.
  80. Sakr WA, Haas GP, Cassin BF, et al.: The frequency of carcinoma and intraepithelial neoplasia of the prostate in young male patients. J Urol 150 (2 Pt 1): 379-85, 1993.
  81. Stamey TA, McNeal JE, Yemoto CM, et al.: Biological determinants of cancer progression in men with prostate cancer. JAMA 281 (15): 1395-400, 1999.
  82. Schwartz KL, Grignon DJ, Sakr WA, et al.: Prostate cancer histologic trends in the metropolitan Detroit area, 1982 to 1996. Urology 53 (4): 769-74, 1999.
  83. Albertsen PC, Hanley JA, Barrows GH, et al.: Prostate cancer and the Will Rogers phenomenon. J Natl Cancer Inst 97 (17): 1248-53, 2005.
  84. Thompson IM, Canby-Hagino E, Lucia MS: Stage migration and grade inflation in prostate cancer: Will Rogers meets Garrison Keillor. J Natl Cancer Inst 97 (17): 1236-7, 2005.
  85. Lefkowitz GK, Sidhu GS, Torre P, et al.: Is repeat prostate biopsy for high-grade prostatic intraepithelial neoplasia necessary after routine 12-core sampling? Urology 58 (6): 999-1003, 2001.
  86. O'Shaughnessy JA, Kelloff GJ, Gordon GB, et al.: Treatment and prevention of intraepithelial neoplasia: an important target for accelerated new agent development. Clin Cancer Res 8 (2): 314-46, 2002.
  87. Edlefsen KL, Mandelson MT, McIntosh MW, et al.: Prostate-specific antigen for prostate cancer screening. Do physician characteristics affect its use? Am J Prev Med 17 (1): 87-90, 1999.
  88. Denis LJ: Prostate cancer screening and prevention: "realities and hope". Urology 46 (3 Suppl A): 56-61, 1995.
  89. Gohagan JK, Levin DL, Prorok JC, et al., eds.: The Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial. Control Clin Trials 21(6 suppl): 249S-406S, 2000.
  90. Labrie F, Candas B, Cusan L, et al.: Screening decreases prostate cancer mortality: 11-year follow-up of the 1988 Quebec prospective randomized controlled trial. Prostate 59 (3): 311-8, 2004.
  91. Legler JM, Feuer EJ, Potosky AL, et al.: The role of prostate-specific antigen (PSA) testing patterns in the recent prostate cancer incidence decline in the United States. Cancer Causes Control 9 (5): 519-27, 1998.
  92. Farkas A, Schneider D, Perrotti M, et al.: National trends in the epidemiology of prostate cancer, 1973 to 1994: evidence for the effectiveness of prostate-specific antigen screening. Urology 52 (3): 444-8; discussion 448-9, 1998.
  93. Roberts RO, Bergstralh EJ, Katusic SK, et al.: Decline in prostate cancer mortality from 1980 to 1997, and an update on incidence trends in Olmsted County, Minnesota. J Urol 161 (2): 529-33, 1999.
  94. Bartsch G, Horninger W, Klocker H, et al.: Prostate cancer mortality after introduction of prostate-specific antigen mass screening in the Federal State of Tyrol, Austria. Urology 58 (3): 417-24, 2001.
  95. Perron L, Moore L, Bairati I, et al.: PSA screening and prostate cancer mortality. CMAJ 166 (5): 586-91, 2002.
  96. Feuer EJ, Merrill RM, Hankey BF: Cancer surveillance series: interpreting trends in prostate cancer--part II: Cause of death misclassification and the recent rise and fall in prostate cancer mortality. J Natl Cancer Inst 91 (12): 1025-32, 1999.
  97. Feuer EJ, Mariotto A, Merrill R: Modeling the impact of the decline in distant stage disease on prostate carcinoma mortality rates. Cancer 95 (4): 870-80, 2002.
  98. Makhlouf AA, Krupski TL, Kunkle D, et al.: The effect of sampling more cores on the predictive accuracy of pathological grade and tumour distribution in the prostate biopsy. BJU Int 93 (3): 271-4, 2004.
  99. Coard KC, Freeman VL: Gleason grading of prostate cancer: level of concordance between pathologists at the University Hospital of the West Indies. Am J Clin Pathol 122 (3): 373-6, 2004.
  100. Carroll PR: Early stage prostate cancer--do we have a problem with over-detection, overtreatment or both? J Urol 173 (4): 1061-2, 2005.
  101. Albertsen PC, Hanley JA, Fine J: 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA 293 (17): 2095-101, 2005.
  102. Etzioni R, Legler JM, Feuer EJ, et al.: Cancer surveillance series: interpreting trends in prostate cancer--part III: Quantifying the link between population prostate-specific antigen testing and recent declines in prostate cancer mortality. J Natl Cancer Inst 91 (12): 1033-9, 1999.
  103. Fleming C, Wasson JH, Albertsen PC, et al.: A decision analysis of alternative treatment strategies for clinically localized prostate cancer. Prostate Patient Outcomes Research Team. JAMA 269 (20): 2650-8, 1993.
  104. Barry MJ, Fleming C, Coley CM, et al.: Should Medicare provide reimbursement for prostate-specific antigen testing for early detection of prostate cancer? Part IV: Estimating the risks and benefits of an early detection program. Urology 46 (4): 445-61, 1995.
  105. Beck JR, Kattan MW, Miles BJ: A critique of the decision analysis for clinically localized prostate cancer. J Urol 152 (5 Pt 2): 1894-9, 1994.
  106. Lu-Yao GL, Yao SL: Population-based study of long-term survival in patients with clinically localised prostate cancer. Lancet 349 (9056): 906-10, 1997.
  107. Grönberg H, Damber L, Jonson H, et al.: Prostate cancer mortality in northern Sweden, with special reference to tumor grade and patient age. Urology 49 (3): 374-8, 1997.
  108. Etzioni R, Gulati R, Tsodikov A, et al.: The prostate cancer conundrum revisited: treatment changes and prostate cancer mortality declines. Cancer 118 (23): 5955-63, 2012.
  109. Coley CM, Barry MJ, Fleming C, et al.: Early detection of prostate cancer. Part II: Estimating the risks, benefits, and costs. American College of Physicians. Ann Intern Med 126 (6): 468-79, 1997.
  110. Kramer BS, Brown ML, Prorok PC, et al.: Prostate cancer screening: what we know and what we need to know. Ann Intern Med 119 (9): 914-23, 1993.
  111. Chan EC, Sulmasy DP: What should men know about prostate-specific antigen screening before giving informed consent? Am J Med 105 (4): 266-74, 1998.
  112. Schröder FH, Bangma CH: The European Randomized Study of Screening for Prostate Cancer (ERSPC). Br J Urol 79 (Suppl 1): 68-71, 1997.

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Last Updated: February 25, 2014
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