To inform updated recommendations by the Canadian Task Force on Preventive Health Care on screening for prostate cancer in adults aged 18 years and older in primary care. This protocol outlines the planned scope and methods for a series of systematic reviews.
Updates of two systematic reviews and a de novo review will be conducted to synthesize the evidence on the benefits and harms of screening for prostate cancer with a prostate-specific antigen (PSA) and/or digital rectal examination (DRE) (with or without additional information) and patient values and preferences. Outcomes for the benefits of screening include reduced prostate cancer mortality, all-cause mortality, and incidence of metastatic prostate cancer. Outcomes for the harms of screening include false-positive screening tests, overdiagnosis, complications due to biopsy, and complications of treatment including incontinence (urinary or bowel), and erectile dysfunction. The quality of life or functioning (overall and disease-specific) and psychological effects outcomes are considered as a possible benefit or harm. Outcomes for the values and preferences review include quantitative or qualitative information regarding the choice to screen or intention to undergo screening. For the reviews on benefits or harms, we will search for randomized controlled trials, quasi-randomized, and controlled studies in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials. For the review on values and preferences, we will search for experimental or observational studies in MEDLINE, Embase, and PsycInfo. For all reviews, we will also search websites of relevant organizations, gray literature, and reference lists of included studies. Title and abstract screening, full-text review, data extraction, and risk of bias assessments will be completed independently by pairs of reviewers with any disagreements resolved by consensus or by consulting with a third reviewer. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach will be used to assess the certainty of the evidence for each outcome.
The series of systematic reviews will be used by the Canadian Task Force on Preventive Health Care to update their 2014 guideline on screening for prostate cancer in adults aged 18 years and older. Systematic review registration This review has been registered with PROSPERO (CRD42022314407) and is available on the Open Science Framework (osf.io/dm32k).
Systematic reviews. 2022 Oct 26*** epublish ***
Alexandria Bennett, Andrew Beck, Nicole Shaver, Roland Grad, Allana LeBlanc, Heather Limburg, Casey Gray, Ahmed Abou-Setta, Scott Klarenbach, Navindra Persaud, Guylène Thériault, Brett D Thombs, Keith J Todd, Neil Bell, Philipp Dahm, Andrew Loblaw, Lisa Del Giudice, Xiaomei Yao, Becky Skidmore, Elizabeth Rolland-Harris, Melissa Brouwers, Julian Little, David Moher
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. ., School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada., Department of Family Medicine, McGill University, Montreal, Quebec, Canada., Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Canada., Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada., Department of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada., Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada., Lady Davis Institute of the Jewish General Hospital and Faculty of Medicine, McGill University, Montreal, Quebec, Canada., Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada., Urology Section, Minneapolis VA Healthcare System and Department of Urology, University of Minnesota, Minneapolis, Minnesota, USA., Evaluative Clinical Sciences, Odette Cancer Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada., Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada., Independent Information Specialist, Ottawa, Ontario, Canada.