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Published on: November 7, 2025
Screening for prostate cancer: a Cochrane systematic review
Dragan Ilic1, Denise O'Connor, Sally Green
1Monash Institute of Health Services Research, Monash Medical Centre, Monash University, Locked Bag 29, Clayton, VIC, 3168, Australia. dragan.ilic@med.monash.edu.au
Cancer Causes & Control : CCC
|January 9, 2007
Summary
This systematic review found insufficient evidence to confirm if prostate cancer screening reduces mortality. More robust trials are needed to guide decisions on screening effectiveness.
Area of Science:
- Urology
- Oncology
- Evidence-based medicine
Background:
- Prostate cancer is a significant health concern for men worldwide.
- Screening methods, such as prostate-specific antigen (PSA) testing, are widely debated for their effectiveness in reducing mortality.
- Existing evidence from randomized controlled trials (RCTs) on prostate cancer screening is limited and has methodological concerns.
Purpose of the Study:
- To systematically review existing randomized controlled trials (RCTs).
- To determine if prostate cancer screening effectively reduces prostate cancer mortality.
- To assess the current evidence base for informed clinical decision-making.
Main Methods:
- Conducted a systematic search of electronic databases and specialized trial registers.
- Included two randomized controlled trials (RCTs) meeting predefined inclusion criteria.
- Independently reviewed studies, assessed quality, and extracted data.
Main Results:
- Only two RCTs were included, both exhibiting significant methodological weaknesses.
- Meta-analysis and intention-to-screen re-analysis showed no statistically significant difference in prostate cancer mortality between screened and control groups (RR 1.01, 95% CI: 0.80-1.29).
- No robust data exists on screening's impact on quality of life, harms, or economic value.
Conclusions:
- Insufficient evidence currently supports or refutes routine prostate cancer screening for reducing mortality due to limited and biased RCTs.
- Ongoing large-scale multi-center RCTs are expected to provide crucial evidence in the coming years.
- Patients and healthcare professionals await further robust trial results for evidence-based decisions on prostate cancer screening.