JAMA Netw Open: Preferred pathological biopsy or magnetic resonance imaging for age stratization screening for adenocarcinoma?

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Although prostate specific antigen (PSA) screening can be reduced by 20% of prostate cancer-specific mortality, but for most men, over- diagnosis and over-treatment of this harm is considered to be greater than the benefits.

A risk-stratified screening program based on age and polygenic profiles may be more cost-effective and retain the mortality advantages associated with PSA age-based screening, while reducing the number of overdiagnosed cancers.

Based on this, some researchers used age and risk stratification screening strategies to assess the pros and cons and cost-effectiveness of MRI before biopsy and the first biopsy to screen for prostate cancer.

The decision analysis model adopts the life table method and was carried out from December 2019 to July 2020.

The decision analysis model adopts the life table method and was carried out from December 2019 to July 2020.

The benefit damage profile (prostate cancer deaths, quality-adjusted life years, overdiagnosis and biopsy) and cost-effectiveness (from the perspective of the health care system, net monetary benefits) are analyzed.

This hypothetical cohort finally included 4.

Cancer and prostate cancer deaths overdiagnosed through diagnostic pathways

Cancer and prostate cancer deaths overdiagnosed through diagnostic channels Cancer and prostate cancer deaths overdiagnosed through diagnostic channels Cancer and prostate cancer deathsoverdiagnosed through diagnostic channels Cancer and prostate cancer deaths overdiagnosed through diagnostic channels

Evaluation of the net monetary benefits associated with age, risk stratification, and no-screening strategies using MRI priority diagnostic pathways

Use magnetic resonance imaging priority diagnostic approach to assess the net monetary benefits associated with age, risk stratification, and no-screening strategy Use magnetic resonance imaging priority diagnostic approach to assess net monetary benefits associated with age, risk stratification, and no-screening strategy use magnetic Resonance imaging priority diagnostic approach to assess the net monetary benefits associated with age, risk stratification, and no-screening strategies.

In summary, in the decision analysis model of this hypothetical cohort, compared with priority screening for biopsy, the priority diagnosis approach of MRI is associated with the pros and cons of prostate cancer screening and the improvement of cost-effectiveness.

In summary, in the decision analysis model of this hypothetical cohort, compared with priority screening for biopsy, the priority diagnosis approach of MRI is associated with the pros and cons of prostate cancer screening and the improvement of cost-effectiveness.

References: Callender T, Emberton M, Morris S, Pharoah PDP, Pashayan N.
Benefit, Harm, and Cost-effectiveness Associated With Magnetic Resonance Imaging Before Biopsy in Age-based and Risk-stratified Screening for Prostate Cancer.
JAMA Netw Open.
2021;4(3):e2037657.
com/journals/jamanetworkopen/fullarticle/2777401" target="_blank" rel="noopener">doi:10.
1001/jamanetworkopen.
2020.
37657 References: Callender T, Emberton M, Morris S, Pharoah PDP, Pashayan N.
Benefit, Harm, and Cost-effectiveness Associated With Magnetic Resonance Imaging Before Biopsy in Age-based and Risk-stratified Screening for Prostate Cancer.
  JAMA Netw Open.
 2021;4(3):e2037657.
com/journals/jamanetworkopen/fullarticle/2777401" target="_blank" rel="noopener">doi:10.
1001/jamanetworkopen.
2020.
37657References: Callender T, Emberton M, Morris S, Pharoah PDP, Pashayan N.
Benefit, Harm, and Cost-effectiveness Associated With Magnetic Resonance Imaging Before Biopsy in Age-based and Risk-stratified Screening for Prostate Cancer.
  JAMA Netw Open.
 2021;4(3):e2037657.
com/journals/jamanetworkopen/fullarticle/2777401" target="_blank" rel="noopener">doi:10.
1001/jamanetworkopen.
2020.
37657 References: Callender T, Emberton M, Morris S, Pharoah PDP, Pashayan N.
Benefit, Harm, and Cost-effectiveness Associated With Magnetic Resonance Imaging Before Biopsy in Age-based and Risk-stratified Screening for Prostate Cancer.
  JAMA Netw Open.
 2021;4(3):e2037657.
com/journals/jamanetworkopen/fullarticle/2777401" target="_blank" rel="noopener">doi:10.
1001/jamanetworkopen.
2020.
37657 JAMA com/journals/jamanetworkopen/fullarticle/2777401" target="_blank" rel="noopener">Netw Open.
com/journals/jamanetworkopen/fullarticle/2777401" target="_blank" rel="noopener">doi:10.
1001/jamanetworkopen.
2020.
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