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2015 ; 7
(10
): 429-35
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Prostate Cancer for the Internist
#MMPMID26713287
Jaiswal S
; Sarmad R
; Arora S
; Dasaraju R
; Sarmad K
N Am J Med Sci
2015[Oct]; 7
(10
): 429-35
PMID26713287
show ga
In the United States, approximately 240,000 men are diagnosed annually with
prostate cancer. Although effective treatment options are available for
clinically localized cancer, the potential burdensome co-morbidities and
attendant healthcare costs from over diagnosis and over treatment have escalated
the discussion and controversy regarding appropriate screening, diagnosis, and
optimal management of prostate cancer. Although the lifetime risk of developing
prostate cancer is approximately 1 in 6 (~16%), the risk of dying from the
disease is only ~2%. The discrepancy between the cancer incidence and lethality
has led to widespread scrutiny of prostate cancer patient management,
particularly for low-grade, low-stage (indolent) disease. The vast majority of
men diagnosed with clinically localized prostate cancer are treated with
interventional therapies despite studies demonstrating that even without
treatment, prostate cancer-specific mortality is low. A MedLine/PubMed search was
performed using PICO format (Patient, Intervention, Comparison and Outcome)
identifying all relevant articles. No restrictions were used for publication
dates. The terms "Prostate Cancer", "Screening", "Mortality", "Morbidity" yielded
307 results. "Diagnosis", "Prognosis" and "Survival" yielded 1504 results.
Further filters were applied to narrow down the results using keywords "Prostate
cancer screening guidelines 2014", "Beyond PSA", "NCCN Guidelines prostate", "MRI
guided Prostate biopsy" yielding 72, 274, 54 and 568 results respectively. Of
these, approximately 137 articles were found relevant and were reviewed.
References from the reviewed articles were included in the final article.