2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T7fe,Earlier evidence syntheses reached uncertain conclusions about the effect of prostate-specific antigen (PSA)-based screening on prostate cancer (PCa)-specific mortality (PCSM). Extended follow-up from major trials has provided an opportunity to re-evaluate the evidence. To estimate the effect of PSA-based screening versus no screening or usual care on PCSM in individuals engaging in screening. We systematically searched PubMed, MEDLINE, EMBASE, and CENTRAL through October 2025 for randomized controlled trials (RCTs) comparing PSA-based screening with no screening or usual care among adults with prostates. The primary outcome was PCSM at the longest available follow-up. Secondary outcomes were PCSM beyond 12 yr and PCSM closest to 10 yr of follow-up. Risk of bias was assessed using the Risk Of Bias instrument for Use in SysTematic reviews-for RCTs (ROBUST-RCT). Incidence rate ratios were pooled using fixed-effect models. Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. We included 5 RCTs analyzing 721,607 participants aged 45-80 yr of age with 11-23 yr of follow-up. PSA-based screening, with a high certainty in the evidence, demonstrated a reduced risk of PCSM at the longest follow-up (p < 0.001). Secondary analyses suggested greater relative PCSM reduction with longer follow-up. The overall effect was observed despite limitations including differing screening protocols and control-arm contamination, which likely underestimated benefit. With 11-23 yr of follow-up, high-certainty evidence demonstrates that PSA-based PCa screening is associated with reduced PCSM among individuals who engage in screening-a finding that contrasts with earlier evidence syntheses. This finding does not in itself justify population-based screening or imply that every well-informed individual would elect to undergo screening. This PCSM benefit should be weighed against known harms and consider emerging approaches under study that may mitigate these harms.31:T408,Among 52,287 rural patients with breast cancer analyzed, 7,111 (13.6%) were diagnosed at advanced stages. Non-Hispanic Black patients had a significantly higher risk of later-stage diagnosis compared with non-Hispanic White patients (stage 2: odds ratio [OR] 1.4 [95% CI 1.26 to 1.55]; stage 3: OR 1.58 [95% CI 1.38 to 1.82]; and stage 4: OR 1.29 [95% CI 1.07 to 1.54]). Hispanic patients had increased risk of stage 3 breast cancer compared with non-Hispanic patients (OR 1.5, [95% CI 1.03 to 2.20]). Uninsured patients had a progressively higher risk of advanced-stage diagnosis than insured patients (stage 2: OR 1.37 [95% CI 1.12 to 1.68]; stage 3: OR 2.06 [95% CI 1.61 to 2.64]; stage 4: OR 3.88 [95% CI 2.94 to 5.11]). Significant geographic differences were observed, with patients in the East South Central (OR 1.28 [95% CI 1.07 to 1.52]) and West South Central (OR 1.33 [95% CI 1.03 to 1.70]) regions having a significantly higher likelihood of stage 4 breast cancer compared with patients in the West North Central region.32:T6a5,Disparities in breast cancer outcomes are prevalent in rural areas, exacerbated by barriers in access to care. We sought to identify factors associated with advanced-stage breast cancer presentation in the National Cancer Database. Patients with breast cancer residing in rural areas were selected from the National Cancer Database between 2004 and 2021. We used multinomial logistic regression to evaluate clinicopathologic factors associated with stage at diagnosis. Among 52,287 rural patients with breast cancer analyzed, 7,111 (13.6%) were diagnosed at advanced stages. Non-Hispanic Black patients had a significantly higher risk of later-stage diagnosis compared with non-Hispanic White patients (stage 2: odds ratio [OR] 1.4 [95% CI 1.26 to 1.55]; stage 3: OR 1.58 [95% CI 1.38 to 1.82]; and stage 4: OR 1.29 [95% CI 1.07 to 1.54]). Hispanic patients had increased risk of stage 3 breast cancer compared with non-Hispanic patients (OR 1.5, [95% CI 1.03 to 2.20]). Uninsured patients had a progressively higher risk of advanced-stage diagnosis than insured patients (stage 2: OR 1.37 [95% CI 1.12 to 1.68]; stage 3: OR 2.06 [95% CI 1.61 to 2.64]; stage 4: OR 3.88 [95% CI 2.94 to 5.11]). Significant geographic differences were observed, with patients in the East South Central (OR 1.28 [95% CI 1.07 to 1.52]) and West South Central (OR 1.33 [95% CI 1.03 to 1.70]) regions having a significantly higher likelihood of stage 4 breast cancer compared with patients in the West North Central region. Significant geographical differences exist in the diagnosis of late-stage breast cancer in rural populations, which are further exacerbated by demographic factors including race and insurance status.33:T8f7, BACKGROUND: Disparities in breast cancer outcomes are prevalent in rural areas, exacerbated by barriers in access to care. We sought to identify factors associated with advanced-stage breast cancer presentation in the National Cancer Database. STUDY DESIGN: Patients with breast cancer residing in rural areas were selected from the National Cancer Database between 2004 and 2021. We used multinomial logistic regression to evaluate clinicopathologic factors associated with stage at diagnosis. RESULTS: Among 52,287 rural patients with breast cancer analyzed, 7,111 (13.6%) were diagnosed at advanced stages. Non-Hispanic Black patients had a significantly higher risk of later-stage diagnosis compared with non-Hispanic White patients (stage 2: odds ratio [OR] 1.4 [95% CI 1.26 to 1.55]; stage 3: OR 1.58 [95% CI 1.38 to 1.82]; and stage 4: OR 1.29 [95% CI 1.07 to 1.54]). Hispanic patients had increased risk of stage 3 breast cancer compared with non-Hispanic patients (OR 1.5, [95% CI 1.03 to 2.20]). Uninsured patients had a progressively higher risk of advanced-stage diagnosis than insured patients (stage 2: OR 1.37 [95% CI 1.12 to 1.68]; stage 3: OR 2.06 [95% CI 1.61 to 2.64]; stage 4: OR 3.88 [95% CI 2.94 to 5.11]). Significant geographic differences were observed, with patients in the East South Central (OR 1.28 [95% CI 1.07 to 1.52]) and West South Central (OR 1.33 [95% CI 1.03 to 1.70]) regions having a significantly higher likelihood of stage 4 breast cancer compared with patients in the West North Central region. CONCLUSIONS: Significant geographical differences exist in the diagnosis of late-stage breast cancer in rural populations, which are further exacerbated by demographic factors including race and insurance status. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Cancer Screening: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Cancer Screening (modality). Clinician-written summaries and actionable practice insights. 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Three themes emerged: (1) engagement with screening, (2) influential factors, and (3) compassionate care. SV&A frequently led to avoidance of intimate examinations; trauma-informed approaches emphasizing trust, communication, choice, and control were linked to improved engagement and more positive experiences.","limitations":"- Evidence on screening uptake differences remains mixed, limiting firm conclusions about prevalence.\n- Restricted to English-language studies from OECD countries, reducing generalizability.\n- Narrative synthesis only — no meta-analysis of quantitative outcomes possible.","practice_takeaway":"Clinicians offering cervical screening should adopt trauma-informed, compassionate approaches — prioritizing explicit communication, patient choice, and control during intimate examinations — to better support women who have experienced SV&A. Enhancing care at each stage of the screening process, not just the speculum examination itself, may meaningfully improve engagement for this group."}},{"doi":"10.1080/13814788.2026.2689646","pmid":"42340409","title":"Breast cancer screening in Europe and the role of general practitioners: A 32-country comparative survey","journal_title":"European Journal of General Practice","journal_issn":"1381-4788","published_at":"2026-06-24T00:00:00.000Z","url":"https://doi.org/10.1080/13814788.2026.2689646","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-02T13:33:22.240Z","updated_at":"2026-07-02T13:33:22.240Z","tags":[{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"category","value":"Primary Health Care","value_numeric":null},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"condition","value":"Breast Cancer","value_numeric":null},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"modality","value":"Cancer Screening","value_numeric":null},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"modality","value":"Mammography","value_numeric":null},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"sample_size","value":"n=32","value_numeric":32},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"study_design","value":"Cross-Sectional Survey","value_numeric":null},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"warning","value":"Causal inference between GP involvement level and uptake rates cannot be drawn from this cross-sectional design — confounding by healthcare system maturity and resources is likely.","value_numeric":null},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"warning","value":"Sample size tag reflects 32 countries, not individual patients — this is an ecological/key-informant survey, not a patient-level study.","value_numeric":null},{"paper_doi":"10.1080/13814788.2026.2689646","tag_type":"warning","value":"Screening uptake data are observational and cross-country comparisons are limited by varying data years (2016–2024) and COVID-19 disruption.","value_numeric":null}],"summaries":{"what_studied":"A cross-sectional survey of 32 European countries (142 key informants) describing breast cancer screening programme structures and the degree of GP involvement, with comparison of screening uptake rates across three GP-involvement tiers.","key_result":"Countries with little/no GP involvement had a median screening uptake of 74.8%, vs. 58.8% for some GP involvement and 40.0% for high GP involvement — a statistically significant difference (Kruskal-Wallis χ²(2) = 8.7, p = 0.013). 15 of 32 countries had minimal GP involvement; 4 relied fully on opportunistic screening driven by GPs.","limitations":"- Uptake data span 2016–2024, including COVID-19 disruption years, limiting direct comparisons.\n- Only 3–8 key informants per country; answers may not reflect regional variation or typical GP views.\n- Social desirability bias is possible since respondents were not anonymous.","practice_takeaway":"Well-organised, centralised population-based screening consistently outperforms GP-led opportunistic models for breast cancer uptake — countries still using opportunistic systems should consider transitioning. Where full transition isn't feasible, structured GP support tools (alert systems, call/recall access, incentives) may help close the uptake gap."}},{"doi":"10.1136/bmj-2026-891902","pmid":"42209014","title":"Prostate cancer screening: Committee rejects calls for mass testing programme despite pressure","journal_title":"BMJ","journal_issn":"1756-1833","published_at":"2026-05-28T00:00:00.000Z","url":"https://doi.org/10.1136/bmj-2026-891902","source_score":12,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-06T13:22:57.049Z","updated_at":"2026-06-06T13:22:57.049Z","tags":[{"paper_doi":"10.1136/bmj-2026-891902","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-891902","tag_type":"category","value":"Medicine, General & Internal","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-891902","tag_type":"condition","value":"Prostate Cancer","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-891902","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-891902","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-891902","tag_type":"modality","value":"Cancer Screening","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-891902","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-891902","tag_type":"study_design","value":"Committee Report / Policy Review","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-891902","tag_type":"warning","value":"Only the title, DOI, journal, and publication date were provided — no abstract, methods, committee identity, or evidence summary were available. All extracted content is inferred from the headline alone and should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-891902","tag_type":"warning","value":"Study design classified as 'Committee Report / Policy Review' based on context; the exact nature of the committee and its authority (e.g., national advisory body, clinical guideline group) is unknown.","value_numeric":null},{"paper_doi":"10.1136/bmj-2026-891902","tag_type":"warning","value":"The 'impact_flag' of practice_changing reflects the policy significance of rejecting a mass screening programme, but the underlying evidence quality cannot be verified from the provided text.","value_numeric":null}],"summaries":{"what_studied":"A committee review of proposals for a mass population-based prostate cancer screening programme, evaluating whether widespread PSA or related testing should be adopted.","key_result":"The committee rejected calls for a mass prostate cancer screening programme despite external pressure to implement one.","limitations":"The source text provides only a headline and metadata — no detailed methodology, evidence synthesis, or committee rationale is available to assess the basis for the decision.","practice_takeaway":"A formal screening committee has declined to endorse mass prostate cancer testing; clinicians should continue to follow current individualised, shared-decision-making approaches for prostate cancer screening rather than expecting a population-wide programme in the near term."}},{"doi":"10.1016/j.eururo.2026.04.005","pmid":"42091407","title":"Effect of Prostate Cancer Screening with Prostate-specific Antigen Testing on Long-term Prostate Cancer–specific Mortality: A Systematic Review and Meta-analysis of Randomized Controlled Trials","journal_title":"European Urology","journal_issn":"0302-2838","published_at":"2026-05-07T00:00:00.000Z","url":"https://doi.org/10.1016/j.eururo.2026.04.005","source_score":13,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-08","doi":"10.1016/j.eururo.2026.04.005","days":"7","issn":"0302-2838","rank":"9","field":"Clinical Medicine","score":"13","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":{"doi":"10.1016/j.eururo.2026.04.005","title":"Effect of Prostate Cancer Screening with Prostate-specific Antigen Testing on Long-term Prostate Cancer-specific Mortality: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","journal":"European urology","methods":"","results":"","abstract":"$30","keywords":["Mortality","Prostate cancer","Screening"],"pubmed_id":"42091407","conclusions":"","publication_date":"2026-05-07T00:00:00"},"crossref":{"DOI":"10.1016/j.eururo.2026.04.005","URL":"https://doi.org/10.1016/j.eururo.2026.04.005","ISSN":["0302-2838"],"link":[{"URL":"https://api.elsevier.com/content/article/PII:S030228382602107X?httpAccept=text/xml","content-type":"text/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://api.elsevier.com/content/article/PII:S030228382602107X?httpAccept=text/plain","content-type":"text/plain","content-version":"vor","intended-application":"text-mining"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Effect of Prostate Cancer Screening with Prostate-specific Antigen Testing on Long-term Prostate Cancer–specific Mortality: A Systematic Review and Meta-analysis of Randomized Controlled Trials"],"author":[{"given":"David-Dan","family":"Nguyen","sequence":"first","affiliation":[]},{"given":"Borna","family":"Tadayon Najafabadi","sequence":"additional","affiliation":[]},{"given":"Lauren","family":"Lin","sequence":"additional","affiliation":[]},{"given":"Jethro C.C.","family":"Kwong","sequence":"additional","affiliation":[]},{"given":"Earl","family":"Miller","sequence":"additional","affiliation":[]},{"given":"Alexandre R.","family":"Zlotta","sequence":"additional","affiliation":[]},{"given":"Neil E.","family":"Fleshner","sequence":"additional","affiliation":[]},{"given":"Amanda E.","family":"Hird","sequence":"additional","affiliation":[]},{"given":"Aisha K.","family":"Lofters","sequence":"additional","affiliation":[]},{"given":"Christopher J.D.","family":"Wallis","sequence":"additional","affiliation":[]},{"given":"Laura C.","family":"Rosella","sequence":"additional","affiliation":[]},{"given":"Philipp","family":"Dahm","sequence":"additional","affiliation":[]},{"given":"Gordon","family":"Guyatt","sequence":"additional","affiliation":[]},{"given":"Girish S.","family":"Kulkarni","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2026,5]]},"member":"78","prefix":"10.1016","source":"Crossref","volume":null,"created":{"date-time":"2026-05-05T20:50:04Z","timestamp":1778014204000,"date-parts":[[2026,5,5]]},"indexed":{"date-time":"2026-05-05T21:14:37Z","timestamp":1778015677042,"date-parts":[[2026,5,5]]},"license":[{"URL":"https://www.elsevier.com/tdm/userlicense/1.0/","start":{"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000,"date-parts":[[2026,5,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://www.elsevier.com/legal/tdmrep-license","start":{"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000,"date-parts":[[2026,5,1]]},"delay-in-days":0,"content-version":"tdm"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://linkinghub.elsevier.com/retrieve/pii/S030228382602107X"}},"subtitle":[],"assertion":[{"name":"publisher","label":"This article is maintained by","value":"Elsevier"},{"name":"articletitle","label":"Article Title","value":"Effect of Prostate Cancer Screening with Prostate-specific Antigen Testing on Long-term Prostate Cancer–specific Mortality: A Systematic Review and Meta-analysis of Randomized Controlled Trials"},{"name":"journaltitle","label":"Journal Title","value":"European Urology"},{"name":"articlelink","label":"CrossRef DOI link to publisher maintained version","value":"https://doi.org/10.1016/j.eururo.2026.04.005"},{"name":"content_type","label":"Content Type","value":"article"},{"name":"copyright","label":"Copyright","value":"© 2026 European Association of Urology. 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Urology"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1016/j.eururo.2026.04.005","is_oa":false,"title":"Effect of Prostate Cancer Screening with Prostate-specific Antigen Testing on Long-term Prostate Cancer–specific Mortality: A Systematic Review and Meta-analysis of Randomized Controlled Trials","updated":"2026-05-06T13:23:02+00:00","published_date":"2026-05-01","best_oa_location":null}},"created_at":"2026-05-09T13:22:19.396Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"condition","value":"Prostate Cancer","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"generic","value":"prostate-specific antigen testing","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"modality","value":"Cancer Screening","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"sample_size","value":"n=721607","value_numeric":721607},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"study_design","value":"Systematic Review and Meta-analysis","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"warning","value":"The meta-analysis pools trials with heterogeneous screening protocols and variable control-arm contamination; pooled effect size is not numerically reported in the abstract, so no specific incidence rate ratio is included in the summary.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"warning","value":"The paper's DOI and publication date (May 2026) are in the future relative to typical citation norms but consistent with today's date provided. No fabricated data were used.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.04.005","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — authors explicitly note this finding does not by itself justify population-based screening; individual shared decision-making remains essential.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis of 5 RCTs (n=721,607 adults aged 45–80) evaluated the effect of PSA-based prostate cancer screening versus no screening or usual care on prostate cancer–specific mortality (PCSM), with follow-up ranging from 11 to 23 years.","key_result":"With high-certainty evidence (GRADE), PSA-based screening significantly reduced PCSM at longest follow-up (p<0.001); secondary analyses indicated greater relative PCSM reduction with longer follow-up durations (beyond 12 years).","limitations":"- Differing screening protocols across trials limit direct comparability.\n- Control-arm contamination (some participants receiving PSA testing outside the trial) likely **underestimates** the true benefit.\n- The analysis does not address harms such as overdiagnosis and overtreatment.","practice_takeaway":"High-certainty evidence now supports that PSA-based screening reduces prostate cancer death over long follow-up — a shift from earlier uncertain conclusions. Clinicians should discuss this mortality benefit alongside known harms (overdiagnosis, overtreatment) when counseling patients about screening decisions."}},{"doi":"10.1097/ju.0000000000005094","pmid":"42048783","title":"Shared Decision-Making for Prostate Cancer Screening Is a System Responsibility","journal_title":"Journal of Urology","journal_issn":"0022-5347","published_at":"2026-04-28T00:00:00.000Z","url":"https://doi.org/10.1097/ju.0000000000005094","source_score":9,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-14T13:24:59.117Z","updated_at":"2026-08-14T13:24:59.117Z","tags":[{"paper_doi":"10.1097/ju.0000000000005094","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000005094","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000005094","tag_type":"condition","value":"Prostate Cancer","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000005094","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000005094","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000005094","tag_type":"modality","value":"Cancer Screening","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000005094","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000005094","tag_type":"study_design","value":"Editorial / Perspective","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000005094","tag_type":"warning","value":"impact_flag of 'practice_changing' is applied cautiously given the systemic policy focus of the title, but may overstate impact without full-text confirmation.","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000005094","tag_type":"warning","value":"No abstract or full text was provided — summary is based solely on title, journal, DOI, and publication metadata. Key result could not be extracted due to absence of data.","value_numeric":null},{"paper_doi":"10.1097/ju.0000000000005094","tag_type":"warning","value":"Study design is inferred as editorial/perspective based on the title framing; this has not been confirmed from full text.","value_numeric":null}],"summaries":{"what_studied":"The paper examines shared decision-making (SDM) for prostate cancer screening, arguing that the responsibility for implementing SDM lies at the health system level rather than solely with individual clinicians or patients.","limitations":"No primary data or clinical trial reported; conclusions are based on perspective or editorial argument rather than empirical evidence.","practice_takeaway":"Health systems — not just individual clinicians — should build structures and workflows that reliably support shared decision-making for prostate cancer screening. Clinicians should advocate for system-level changes (e.g., decision aids, navigator programs) to ensure SDM happens consistently for all eligible patients."}},{"doi":"10.1002/ijc.70492","pmid":"42015666","title":"Evaluating the Impact of Age on Prostate Cancer Overdiagnosis Using Long‐Term Follow‐Up From the\n CAP\n Randomised Trial","journal_title":"International Journal of Cancer","journal_issn":"0020-7136","published_at":"2026-04-22T00:00:00.000Z","url":"https://doi.org/10.1002/ijc.70492","source_score":76,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-09T13:22:14.698Z","updated_at":"2026-05-09T13:22:14.698Z","tags":[{"paper_doi":"10.1002/ijc.70492","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"condition","value":"Prostate Cancer","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"generic","value":"prostate-specific antigen","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"modality","value":"Cancer Screening","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"sample_size","value":"n=189386","value_numeric":189386},{"paper_doi":"10.1002/ijc.70492","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"warning","value":"Competing mortality rates are population-level figures from England (2021–23) and may not apply to other healthcare settings or countries.","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"warning","value":"Overdiagnosis estimates are derived from a single one-off PSA screen; results may underestimate overdiagnosis in repeated/organised screening programmes.","value_numeric":null},{"paper_doi":"10.1002/ijc.70492","tag_type":"warning","value":"The level of evidence tag reflects the RCT source data, but the overdiagnosis projections by age group are modelled estimates rather than directly observed trial outcomes.","value_numeric":null}],"summaries":{"what_studied":"Using 15-year follow-up data from the CAP randomised trial (n=189,386 men), this study estimated how age at PSA screening affects prostate cancer overdiagnosis — defined as cancers detected by a one-off PSA screen that would never have been diagnosed in the patient's lifetime — using competing-risks methods and English male mortality rates (2021–23).","key_result":"Absolute excess cumulative incidence at 15 years was just 0.14% (screening arm 7.08% vs. control 6.94%), yielding an overall overdiagnosis fraction of ~11.7% of screen-detected cases. However, overdiagnosis risk rose sharply with age: 16% at age 50, 32% at age 70, and 58% at age 80.","limitations":"Estimates are based on a single prevalent PSA screen (not repeated screening), so overdiagnosis rates may differ in organised multi-round programmes. Competing mortality rates are drawn from English population data (2021–23) and may not generalise to other countries or time periods.","practice_takeaway":"Prostate cancer overdiagnosis is low for men screened in their 50s but rises sharply after age 70. Clinicians and policymakers should scrutinise opportunistic PSA testing policies that result in high screening rates in older men."}},{"doi":"10.1001/jama.2026.1269","pmid":"41941225","title":"Screening for Breast Cancer—Reply","journal_title":"JAMA","journal_issn":"0098-7484","published_at":"2026-04-06T00:00:00.000Z","url":"https://doi.org/10.1001/jama.2026.1269","source_score":433,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-18T13:25:18.039Z","updated_at":"2026-05-23T13:24:40.804Z","tags":[{"paper_doi":"10.1001/jama.2026.1269","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"category","value":"Medicine, General & Internal","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"condition","value":"Breast Cancer","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"modality","value":"Cancer Screening","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"study_design","value":"Letter / Commentary","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"study_design","value":"Letter / Correspondence","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"study_design","value":"Letter / Reply","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"Full structured extraction is not possible without access to the article body. Clinicians should retrieve the full text for clinical guidance.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"No clinical data, population details, or outcomes were available to extract.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"Only the paper metadata (title, DOI, journal, date) was provided — no abstract or full text. All summary fields are null due to insufficient source content.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"Only the publisher landing page text is available — the full article is behind a paywall. Summary content is limited to the visible excerpt and cannot reflect the full discussion or any cited data.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the authors' framing of WISDOM results as supporting a paradigm shift, not independently verified trial data from this document.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"The provided source text contains only metadata (title, DOI, journal, date) with no abstract or full-text content. All summary fields have been set to null due to insufficient data. Tags and suggested searches are inferred from the title alone.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"The provided source text contains only metadata (title, DOI, journal, publication date) with no abstract or body text. All summary fields have been set to null due to insufficient content. Tags and suggested searches are based solely on the title.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"The source text provided contains only bibliographic metadata (title, DOI, journal, publication date) with no abstract or body text. All summary fields are set to null because no clinical content could be extracted. Tags and suggested searches are based solely on the title.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"This appears to be a correspondence/reply item in JAMA, not a primary research article. Study design classification as 'Letter / Reply' is inferred from the title format.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"This appears to be a reply letter (correspondence), not a primary research article. Level of evidence and sample size cannot be determined.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"This appears to be a 'Reply' letter or correspondence item in JAMA, not a primary research article. Study design, level of evidence, and sample size cannot be determined from available information.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"This appears to be a reply letter or correspondence piece in JAMA, not a primary research article. Study design and level of evidence cannot be reliably determined from the title alone.","value_numeric":null},{"paper_doi":"10.1001/jama.2026.1269","tag_type":"warning","value":"This is a reply letter (commentary), not a primary research article; level of evidence is rated accordingly.","value_numeric":null}],"summaries":{"what_studied":"This is a reply letter commenting on the WISDOM trial results, which evaluated a risk-based strategy for breast cancer screening as an alternative to a one-size-fits-all approach, aiming to personalize screening and prevention based on individual risk stratification.","key_result":"The WISDOM trial demonstrated that a risk-based screening strategy can stratify population risk and facilitate personalized screening and prevention while preserving safety; no specific numerical outcomes are provided in the available text.","limitations":"Only the publisher page and abstract-level text are available — full text is paywalled, so detailed methods, outcomes, and data cannot be assessed.","practice_takeaway":"A risk-based approach to breast cancer screening may allow clinicians to tailor screening intensity to individual risk profiles rather than applying uniform guidelines. Clinicians should follow WISDOM trial findings as evidence supporting personalized screening continues to develop."}},{"doi":"10.1016/j.eururo.2026.03.013","pmid":"41916801","title":"Re: European Study of Prostate Cancer Screening — 23-Year Follow-up","journal_title":"European Urology","journal_issn":"0302-2838","published_at":"2026-03-31T00:00:00.000Z","url":"https://doi.org/10.1016/j.eururo.2026.03.013","source_score":50,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-07T13:22:58.005Z","updated_at":"2026-08-07T13:22:58.005Z","tags":[{"paper_doi":"10.1016/j.eururo.2026.03.013","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.013","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.013","tag_type":"condition","value":"Prostate Cancer","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.013","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.013","tag_type":"modality","value":"Cancer Screening","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.013","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.013","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.013","tag_type":"warning","value":"Publication date of 2026-03-31 is in the future relative to the ERSPC's known published follow-up data; content could not be independently verified.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.013","tag_type":"warning","value":"The full paper text was not provided — only the title, DOI, journal, and publication date were supplied. All structured data above is inferred from the title and known ERSPC trial context, not extracted from the actual manuscript. Key results, sample size, specific limitations, and practice takeaways cannot be reliably populated without the source text.","value_numeric":null},{"paper_doi":"10.1016/j.eururo.2026.03.013","tag_type":"warning","value":"The study design tag of 'Randomized Controlled Trial' is inferred from the known ERSPC trial design; this paper may be a letter, commentary, or sub-analysis rather than a primary RCT report.","value_numeric":null}],"summaries":{"what_studied":"This appears to be a follow-up report or correspondence related to the European Randomized Study of Screening for Prostate Cancer (ERSPC), evaluating outcomes at 23 years of follow-up.","limitations":"The paper text was not provided beyond the title and metadata, so specific results, sample sizes, and limitations cannot be extracted or verified."}},{"doi":"10.1097/xcs.0000000000001759","pmid":"41810795","title":"Evaluating Factors Associated with Advanced-Stage Breast Cancer Presentation in Rural Patients in the National Cancer 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excerpt.","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001759","tag_type":"warning","value":"Sex was not explicitly stated in the abstract as female-only, but breast cancer population in NCDB is overwhelmingly female; tagged accordingly with a note of minor uncertainty.","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001759","tag_type":"warning","value":"Study design is labeled retrospective cohort based on NCDB methodology; the paper does not use this exact label explicitly.","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001759","tag_type":"warning","value":"The definition of “rural” and covariates adjusted for in the models were not specified in the provided text.","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001759","tag_type":"warning","value":"The paper is listed as published 2026-03-26 but today's date is May 14, 2026 — treated as a recently published study with no additional concerns.","value_numeric":null}],"summaries":{"limitations":"- Retrospective database study; causality cannot be established.\n- The National Cancer Database captures only facility-reported cases (~70% of U.S. cancers), which may introduce selection bias.\n- Insurance status and rurality are broad categories that may not capture nuanced access-to-care barriers.","what_studied":"Registry analysis of rural breast cancer cases in the National Cancer Database (2004–2021) assessing clinicopathologic and demographic factors associated with stage at diagnosis using multinomial logistic regression.","key_result":"Among 52,287 rural patients, 7,111 (13.6%) were diagnosed at advanced stages. Later-stage diagnosis was more likely for Non-Hispanic Black vs Non-Hispanic White patients (stage 2 OR 1.4 [95% CI 1.26–1.55]; stage 3 OR 1.58 [1.38–1.82]; stage 4 OR 1.29 [1.07–1.54]); for Hispanic patients at stage 3 (OR 1.5 [1.03–2.20]); for uninsured vs insured patients (stage 2 OR 1.37 [1.12–1.68]; stage 3 OR 2.06 [1.61–2.64]; stage 4 OR 3.88 [2.94–5.11]); and for those in East South Central (OR 1.28 [1.07–1.52]) and West South Central (OR 1.33 [1.03–1.70]) vs West North Central at stage 4.","practice_takeaway":"In rural settings, expect higher odds of advanced-stage breast cancer at diagnosis among Non-Hispanic Black and uninsured patients and in East/West South Central regions; use this to focus timely screening and diagnostic access."}}],"initialOffset":9,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Cancer Screening"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Cancer Screening"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Cancer Screening"}}}]]

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