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Medicina (Buenos Aires)

Print version ISSN 0025-7680On-line version ISSN 1669-9106

Abstract

CASAL, E. R.  and  MAJDALANI, M. P.. Controversial guidelines in early diagnosis of prostate cancer. Medicina (B. Aires) [online]. 2003, vol.63, n.1, pp.77-81. ISSN 0025-7680.

In prostate cancer prevention the American College of Physicians has endorsed a clinical practice guideline: it is recommended that physicians share the decision with the patient. There is no information about its adaptation to actual circumstances and particularly in our country. This presentation has the aim of analyzing the evidence and introduces a local perspective. There is no demonstration of survival or life quality improvement in preventing prostate cancer. Therapeutic interventions have a high rate of associated morbidity and mortality. Although desirable, sharing decisions has not yet proved its validity. In our country, due to the fragile equilibrium between risks and benefits, it seems advisable to wait for stronger scientific evidence. It is recommended to the clinician to: abstain from offering early diagnosis in the healthy adult, be reluctant when asked, share decisions when it seems advisable based on patient's characteristics and inform about the probability of prostate cancer in high risk groups.

Keywords : Prostatic neoplasm; Prevention and control; Clinical practice guidelines.

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