Favor poner atencion a la conclusion.
Articulo completo: RS Screening Ca Prostata BMJ.pdf
Para continuar con lo de Ca de prostata, una revision sistematica del BMJ:
OBJECTIVE: To examine the evidence on the benefits and harms of screening for prostate cancer.
DESIGN: Systematic review and meta-analysis of randomised controlled trials.
SOURCES: Electronic databases including Medline, Embase, CENTRAL,
abstract proceedings, and reference lists up to July 2010. Review
methods Included studies were randomised controlled trials comparing
screening by prostate specific antigen with or without digital rectal
examination versus no screening. Data abstraction and assessment of
methodological quality with the GRADE approach was assessed by two
independent reviewers and verified by the primary investigator.
Mantel-Haenszel and inverse variance estimates were calculated and
pooled under a random effects model expressing data as relative risks
and 95% confidence intervals.
RESULTS: Six randomised controlled
trials with a total of 387 286 participants that met inclusion criteria
were analysed. Screening was associated with an increased probability
of receiving a diagnosis of prostate cancer (relative risk 1.46, 95%
confidence interval 1.21 to 1.77; P<0.001) and stage I prostate
cancer (1.95, 1.22 to 3.13; P=0.005). There was no significant effect
of screening on death from prostate cancer (0.88, 0.71 to 1.09; P=0.25)
or overall mortality (0.99, 0.97 to 1.01; P=0.44). All trials had one
or more substantial methodological limitations. None provided data on
the effects of screening on participants' quality of life. Little
information was provided about potential harms associated with
screening.CONCLUSIONS: The existing evidence from randomised
controlled trials does not support the routine use of screening for
prostate cancer with prostate specific antigen with or without digital