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      Cancer screening in the United States, 2019: A review of current American Cancer Society guidelines and current issues in cancer screening

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          Mortality results from a randomized prostate-cancer screening trial.

          The effect of screening with prostate-specific-antigen (PSA) testing and digital rectal examination on the rate of death from prostate cancer is unknown. This is the first report from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial on prostate-cancer mortality. From 1993 through 2001, we randomly assigned 76,693 men at 10 U.S. study centers to receive either annual screening (38,343 subjects) or usual care as the control (38,350 subjects). Men in the screening group were offered annual PSA testing for 6 years and digital rectal examination for 4 years. The subjects and health care providers received the results and decided on the type of follow-up evaluation. Usual care sometimes included screening, as some organizations have recommended. The numbers of all cancers and deaths and causes of death were ascertained. In the screening group, rates of compliance were 85% for PSA testing and 86% for digital rectal examination. Rates of screening in the control group increased from 40% in the first year to 52% in the sixth year for PSA testing and ranged from 41 to 46% for digital rectal examination. After 7 years of follow-up, the incidence of prostate cancer per 10,000 person-years was 116 (2820 cancers) in the screening group and 95 (2322 cancers) in the control group (rate ratio, 1.22; 95% confidence interval [CI], 1.16 to 1.29). The incidence of death per 10,000 person-years was 2.0 (50 deaths) in the screening group and 1.7 (44 deaths) in the control group (rate ratio, 1.13; 95% CI, 0.75 to 1.70). The data at 10 years were 67% complete and consistent with these overall findings. After 7 to 10 years of follow-up, the rate of death from prostate cancer was very low and did not differ significantly between the two study groups. (ClinicalTrials.gov number, NCT00002540.) 2009 Massachusetts Medical Society
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            Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement.

            Colorectal cancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134,000 persons will be diagnosed with the disease, and about 49,000 will die from it. Colorectal cancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectal cancer is 68 years.
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              Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society.

              Breast cancer is a leading cause of premature mortality among US women. Early detection has been shown to be associated with reduced breast cancer morbidity and mortality.
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                Author and article information

                Journal
                CA: A Cancer Journal for Clinicians
                CA A Cancer J Clin
                Wiley
                0007-9235
                1542-4863
                February 20 2019
                May 2019
                March 15 2019
                May 2019
                : 69
                : 3
                : 184-210
                Affiliations
                [1 ]Vice‐President, Cancer Screening, and Director, Center for Quality Cancer Screening and Research, Cancer Control Department American Cancer Society Atlanta GA
                [2 ]Director, Guidelines Process, Cancer Control Department American Cancer Society Atlanta GA
                [3 ]Vice President, Cancer Control Interventions, Cancer Control Department American Cancer Society Atlanta GA
                [4 ]Senior Principal Scientist, Surveillance and Health Services Research American Cancer Society Atlanta GA
                [5 ]Senior Director, Human Papillomavirus‐Related and Women's Cancers, Cancer Control Department American Cancer Society Atlanta GA
                [6 ]Chief Cancer Control Officer American Cancer Society Atlanta GA
                Article
                10.3322/caac.21557
                761b87b0-3cf0-4e7c-a608-8eb35119b4fe
                © 2019

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