Screening and clinical management of prostate cancer - A cross-national comparison

Objectives: The objectives of the study were to identify the current standa rds of clinical practice regarding prostate cancer screening in western Eur ope, Canada, and the United States, and to highlight major characteristics of current prostate cancer screening programs or patterns of practice. Methods: We performed a semi-structured interview by means of a self-admini stered questionnaire sent by fax to 26 institutes pertaining to the Interna tional Network of Agencies for Health Technology Assessment. Results: None of the countries surveyed had a formal national screening pol icy. Despite that, all the countries answering the questionnaire had discre tionary, public-financed screening practices. Moreover, some scientific and professional organizations recommended population screening for prostate c ancer, and few of the surveyed countries offered it as experimental practic e within a randomized controlled trial. Survey results showed variation reg arding screening policies, in particular test of choice, age cut-off points , and treatment prescribed for positive test results. Conclusions: Despite the lack of conclusive evidence on the benefits of pro state cancer screening, the availability of simple and easy-to-administer t ests has lead to an enormous variation on screening policies around the wor ld. Practice variations also affect prostate cancer therapy.